Routine hematological parameters are associated with short- and long-term prognosis of patients with ischemic stroke

J Clin Lab Anal. 2018 Feb;32(2):e22244. doi: 10.1002/jcla.22244. Epub 2017 May 22.

Abstract

Background: Previous studies indicated that some routine hematological parameters are associated with the prognosis of ischemic stroke (IS), but none of study has evaluated them simultaneously. The aim of this study was to investigate the prognostic value of routine hematological parameters in IS patients.

Methods: Using medical record database, we retrospectively reviewed the patients with IS admitted in Gansu Province Hospital between June 2014 and July 2015. The prognostic value of routine hematological parameters on admission was analyzed using logistic regression model, receiver operating characteristic (ROC) curve analysis and Cox proportional hazards model.

Results: Patients with hospital mortality had significantly higher white blood cell (WBC), neutrophil, neutrophil to lymphocyte ratio (NLR), red blood cell distribution width (RDW) and National Institutes of Health Stroke Scale (NIHSS), while their lymphocyte, monocyte, and eosinophil were significantly lower. The area under ROC curve (AUC) for eosinophil, neutrophil, WBC, RDW, NLR, monocyte, and lymphocyte were 0.74 (95% CI, 0.67-0.82), 0.76 (95% CI, 0.67-0.84), 0.72 (95% CI, 0.64-0.81), 0.65 (95% CI, 0.56-0.73), 0.76 (95% CI, 0.68-0.84), 0.67 (95% CI, 0.59-0.76), and 0.75 (95% CI, 0.67-0.83), respectively. In a multivariable logistical regression model, only WBC, NLR, and NIHSS were independently associated with hospital mortality. In a multivariable model, age, NIHSS, RDW, NLR, and eosinophil were independent prognostic factors for all-cause mortality.

Conclusion: Red blood cell distribution width, NLR and eosinophil are independent prognostic factors for IS.

Keywords: hematological parameters; ischemic stroke; prognosis; red blood cell distribution; retrospective study.

MeSH terms

  • Aged
  • Blood Cell Count*
  • Brain Ischemia* / blood
  • Brain Ischemia* / diagnosis
  • Brain Ischemia* / epidemiology
  • Erythrocyte Indices*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Stroke* / blood
  • Stroke* / diagnosis
  • Stroke* / epidemiology