Admission Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker of Outcomes in Large Vessel Occlusion Strokes

Background and Purpose- The purpose of this study is to evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR) at admission with safety and efficacy outcomes in acute stroke patients with large vessel occlusion after mechanical thrombectomy. Methods- Consecutive large vessel occlusio...

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Bibliographic Details
Published in:Stroke (1970) Vol. 49; no. 8; p. 1985
Main Authors: Goyal, Nitin, Tsivgoulis, Georgios, Chang, Jason J, Malhotra, Konark, Pandhi, Abhi, Ishfaq, Muhammad F, Alsbrook, Diana, Arthur, Adam S, Elijovich, Lucas, Alexandrov, Andrei V
Format: Journal Article
Language:English
Published: United States 01.08.2018
Subjects:
Aged
Biomarkers - blood
Cerebrovascular Disorders - blood
Cerebrovascular Disorders - diagnostic imaging
Female
Humans
Lymphocytes - metabolism
Male
Middle Aged
Neutrophils - metabolism
Patient Admission - trends
Prognosis
Prospective Studies
Retrospective Studies
Stroke - blood
Stroke - diagnostic imaging
Treatment Outcome
mortality
lymphocyte count
neutrophils
stroke
thrombectomy
ISSN:1524-4628, 1524-4628
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Summary:Background and Purpose- The purpose of this study is to evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR) at admission with safety and efficacy outcomes in acute stroke patients with large vessel occlusion after mechanical thrombectomy. Methods- Consecutive large vessel occlusion patients treated with mechanical thrombectomy during a 4-year period were evaluated. Outcome measures included symptomatic intracranial hemorrhage, 3-month mortality, successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b/3), and 3-month functional independence (modified Rankin Scale scores of 0-2). Results- A total of 293 large vessel occlusion patients underwent mechanical thrombectomy (median admission NLR, 3.5; interquartile range [IQR], 1.7-6.8). In initial univariable analyses, higher median admission NLR values were documented in patients with symptomatic intracranial hemorrhage (8.5; IQR, 4.7-11.3) versus (3.9; IQR, 1.9-6.5); P<0.001 and individuals who were dead at 3-months (5.4; IQR, 2.8-9.6) versus (4.0; IQR, 1.8-6.4); P=0.004. Lower NLR values were recorded in patients with 3-month functional independence (3.7; IQR, 1.7-6.5) versus (4.3; IQR, 2.6-8.3); P=0.039. After adjustment for potential confounders, a 1-point increase in NLR was independently associated with higher odds of symptomatic intracranial hemorrhage (odds ratio, 1.11; 95% CI, 1.03-1.20; P=0.006) and 3-month mortality (odds ratio, 1.08; 95% CI, 1.01-1.16; P=0.014). Conclusions- Higher admission NLR is an independent predictor of symptomatic intracranial hemorrhage and 3-month mortality in large vessel occlusion patients treated with mechanical thrombectomy, and it may identify a target group for testing adjunctive anti-inflammatory therapies.
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ISSN:1524-4628
1524-4628
DOI:10.1161/STROKEAHA.118.021477