Dynamic Neutrophil-Lymphocyte Ratios Predict Short-term Prognostic Outcome of Thrombolysis in Patients with Acute Ischemic Stroke

Neurotox Res. 2021 Oct;39(5):1678-1687. doi: 10.1007/s12640-021-00382-6. Epub 2021 Jun 17.

Abstract

Aim: The main purpose of this study was to investigate the dynamic changes of neutrophils-lymphocytes ratios (NLRs) in patients with acute ischemic stroke (AIS) and their relationships with 3-month prognostic outcomes.

Methods: Two hundred ninety-one patients with AIS were included in this study, followed up for 3 months. At admission, 1 and 7 days after recombinant tissue plasminogen activator (r-tPA) injection, blood samples were obtained. Outcome events included excellent outcome, good outcome, and death defined as modified Rankin Scale (mRS) scores of 0-1, 0-2, and 6 respectively.

Results: NLRs measured in admission and 7 days after r-tPA treatment were associated with prognosis outcome after 3 months. Twenty-four-hour NLR is an excellent indicator in forecasting (excellent outcome's the areas under the curve (AUC) = 0.725; good outcome AUC = 0.742; death AUC = 0.759). In addition, we were surprised to find that dynamic increase in NLR within 24 h is significantly related to excellent and good outcomes.

Conclusions: Twenty-four-hour NLR is related to the severity of AIS and poor prognosis, which can help early risk stratification.

Significance: We can predict the prognosis of AIS more accurately. Compared with previous studies, our study has shown the dynamic changes of NLR and its relationship with NIHSS and multiple prognostic.

Keywords: Lymphocytes; NLR; Neutrophils; Prognosis; Thrombolysis.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Brain Ischemia / blood*
  • Brain Ischemia / diagnosis
  • Brain Ischemia / therapy
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Follow-Up Studies
  • Humans
  • Ischemic Stroke / blood*
  • Ischemic Stroke / diagnosis
  • Ischemic Stroke / therapy
  • Lymphocytes / metabolism*
  • Male
  • Middle Aged
  • Neutrophils / metabolism*
  • Predictive Value of Tests
  • Prognosis
  • Thrombolytic Therapy / methods
  • Thrombolytic Therapy / trends*
  • Time Factors
  • Treatment Outcome

Substances

  • Fibrinolytic Agents