Evaluation of Neutrophil-to-Lymphocyte Ratio Among Ischemic Stroke Subtypes and Stroke Severity

Dhrumil Shah, Rajeswari Rajan, A. Batra, I. Anand, A. Saraf, P. Sethi
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引用次数: 1

Abstract

Introduction: Recently, neutrophil-to-lymphocyte ratio (NLR) has been proven to be useful in predicting severity, mortality, and morbidity of stroke. NLR is low cost and yet not used widely as a biomarker to predict prognosis. Aims: We evaluated the association of NLR in severity of stroke and ischemic stroke subtypes. Methodology: A total of 69 subjects with ischemic stroke onset within 24 h were included in the study and categorized according to TOAST classification. National Institutes of Health Stroke Scale was used to determine stroke severity at admission. Samples were obtained within 24 h of stroke onset and NLR measured which was later correlated with severity and subtypes of stroke. Results: NLR and severity of stroke showed statistically significant association (P < .05). Median (interquartile range [IQR]) of NLR was significantly high in severe cases (7.1 [4.03-7.698]), as compared to others. The area under the receiver operating characteristic curve for NLR to predict the stroke severity was 6.07 [area under the curve 0.764; 95% confidence interval: 0.647 to 0.858). When NLR was more than 6.07, there was 90.90% chances of moderate-to-severe stroke and with milder stroke, 93.10% had NLR of less than equal to 6.07. NLR and stroke subtypes also showed statistically significant association (P < .05). Median (IQR) of NLR in embolic stroke was significantly high (4.75 [2.95-8.2]), as compared to other stroke subtypes. Conclusion: NLR, at a cut-off 6, has moderate sensitivity and higher specificity in predicting stroke severity and NLR was high in embolic stroke among other stroke subtypes.
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中性粒细胞/淋巴细胞比值在缺血性卒中亚型和卒中严重程度中的评价
近年来,中性粒细胞与淋巴细胞比值(NLR)已被证明可用于预测中风的严重程度、死亡率和发病率。NLR成本低,但尚未广泛用作预测预后的生物标志物。目的:我们评估NLR与脑卒中严重程度和缺血性脑卒中亚型的关系。方法:将69例24 h内发病的缺血性卒中患者纳入研究,按TOAST分类。入院时采用美国国立卫生研究院卒中量表确定卒中严重程度。在脑卒中发生24小时内采集样本,并测量NLR, NLR随后与脑卒中的严重程度和亚型相关。结果:NLR与脑卒中严重程度有统计学意义(P < 0.05)。重症NLR的中位数(四分位数间距[IQR])明显高于其他病例(7.1[4.03-7.698])。NLR预测脑卒中严重程度的受试者工作特征曲线下面积为6.07,曲线下面积为0.764;95%置信区间:0.647 ~ 0.858)。当NLR大于6.07时,发生中重度卒中的几率为90.90%;当NLR小于6.07时,发生轻度卒中的几率为93.10%。NLR与脑卒中亚型也有统计学意义(P < 0.05)。栓塞性卒中NLR的中位数(IQR)明显高于其他卒中亚型(4.75[2.95-8.2])。结论:NLR在预测脑卒中严重程度方面具有中等敏感性和较高特异性,在其他脑卒中亚型中,NLR在栓塞性脑卒中中较高。
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