The effects of changes in platelet-to-neutrophil ratios 24 hours after intravenous thrombolysis on prognosis in acute ischemic stroke patients

Clin Neurol Neurosurg. 2020 Mar:190:105739. doi: 10.1016/j.clineuro.2020.105739. Epub 2020 Feb 17.

Abstract

Objective: To investigate the prognostic value of Platelet-to-Neutrophil ratio on admission (PNR on admission) and 24 h after intravenous thrombolysis (24 h PNR) in acute ischemic stroke patients (AIS) patients.

Patients and methods: One hundred fifty-one ischemic stroke patients receiving intravenous thrombolysis were retrospectively recruited in this study. Complete blood count evaluations for PNR were conducted on admission and 24 h after the treatment of thrombolysis. The poor outcome at 3months was defined as the modified Rankin Scale of 3-6.

Results: In multivariate logistic regression, PNR on admission (odds ratio [OR] = 0.967, 95 % confidence interval [CI] = 0.939-0.996; P = 0.028), and 24 h PNR(OR = 0.933, 95 %CI = 0.895-0.972; P = 0.004) were all independent indicators for the 3-month poor prognosis in ischemic stroke patients receiving intravenous thrombolysis. The area under the curve of PNR on admission to predict poor functional outcomes at 3 months was 0.645 (95 %CI = 0.558-0.732; P < 0.001), and the best predictive PNR on admission value was 41.35. After the treatment of thrombolysis, the area under the curve of 24 h PNR to predict poor functional outcomes at 3 months was 0.796 (95 %CI = 0.722-0.858; P < 0.001), and the best predictive 24 h PNR value was 31.03.

Conclusions: Both the PNR on admission and 24 h PNR were independently associated with poor functional outcomes. Compared with the PNR on admission, 24 h PNR may serve as a more reliable marker for a poor prognosis in ischemic stroke patients receiving intravenous thrombolysis.

Keywords: 24h PNR; Acute ischemic stroke; Intravenous thrombolysis; PNR; Prognosis.

MeSH terms

  • Administration, Intravenous
  • Aged
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Functional Status
  • Humans
  • Ischemic Stroke / blood
  • Ischemic Stroke / drug therapy*
  • Ischemic Stroke / physiopathology
  • Leukocyte Count*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils*
  • Odds Ratio
  • Platelet Count*
  • Prognosis
  • Severity of Illness Index
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / therapeutic use*

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator