Correlation of neutrophils lymphocyte ratio with functional outcome in intracranial tumour

2021 ◽  
Vol 429 ◽  
pp. 118450
Author(s):  
Indah Youlpi ◽  
Alfansuri Kadri ◽  
Irina Nasution
Keyword(s):  
Functional Outcome ◽  
Intracranial Tumour ◽  
Lymphocyte Ratio

Abstract WP168: Neutrophil to Lymphocyte Ratio is a Useful Predictor of Short-term Functional Outcome in Patients With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Tae Jung Kim ◽  
Min-Kyung Kang ◽  
Kiwoong Nam ◽  
Heejung Mo ◽  
Sang Joon An ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cardiovascular Diseases ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Unfavorable Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Outcome Group ◽  
History Of

Introduction: Inflammation is associated with the initiation and progression of cardiovascular diseases. The neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a prognostic marker in cardiovascular diseases. However, impact of NLR on the functional outcome in patients with ischemic stroke remains unclear. Hypothesis: The aim of the study was to investigate the prognostic role of the NLR in patients with acute ischemic stroke. Methods: A consecutive 1,113 patients who were admitted within 7 days after ischemic stroke onset between March 2010 and December 2014 were included for analysis. The patients were categorized into tertiles on the basis of NLR. We evaluated the short-term outcomes using a modified Rankin Scale (mRS) at three-months after onset of ischemic stroke. We divided patients into two groups with favorable outcome (mRS score ≤2) and unfavorable outcome (mRS score ≥3). We compared the clinical characteristics and NLR between two groups. Results: From all the patients included in this study (mean age, 67.8 years; men, 60.0%), 284 (25.5%) patients had unfavorable outcome. The patients with unfavorable outcome were older and more likely to have atrial fibrillation, history of previous stroke, and diabetes mellitus. In addition, participants with unfavorable outcome tended to have lower body mass index and higher initial NIHSS. The percentage values of the tertile 3 were significantly higher in the unfavorable outcome group (28.3% vs. 47.9%, P < 0.001). After adjustment for covariates, the highest tertile were at an exaggerated risk for unfavorable outcome [Odds ratio (95% confidence interval); tertile 3, 1.75 (1.17 - 2.63), P = 0.007]. Conclusions: This study demonstrated that higher NLR predicted worse outcome at 3 months following acute ischemic stroke. This suggests that NLR could be a useful and reliable prognostic biomarker following acute ischemic stroke.

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

2018 ◽  
Vol 45 (5-6) ◽  
pp. 221-227 ◽  
Author(s):  
Zhenhui Duan ◽  
Huaiming Wang ◽  
Zhen Wang ◽  
Yonggang Hao ◽  
Wenjie Zi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Functional Outcome ◽  
Laboratory Data ◽  
Poor Functional Outcome ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Background and Objective: Endovascular treatment (EVT) is proven to be safe and effective for treating acute large vessel occlusion stroke (LVOS). The neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic stroke. This study aims to explore the relationship between NLR and the clinical outcomes of LVOS patients undergoing EVT. Methods: Patients were selected from the EVT for acUte Anterior circuLation (ACTUAL) ischemic stroke registry. The laboratory data (neutrophil count, lymphocyte count) before EVT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3–6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR with functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality. Results: We eventually included 616 patients (median of age, 66 years; 40.3% female). There were 350 (56.7%) patients achieving mRS of 3–6 at 3 months, 98 (15.9%) patients with sICH, and the mortality at 3 months was 24.8% (153/616). Baseline NLR was independently associated with poor functional outcome (OR 1.58; 95% CI 1.02–2.45; p = 0.039) and sICH (OR 1.84; 95% CI 1.09–3.11; p = 0.023) but showed a trend for predicting 3-month mortality (OR 1.57; 95% CI 0.94–2.65; p = 0.088). Conclusions: NLR independently predicts 3-month functional outcome and sICH but the existence of a trend association with mortality after EVT for acute anterior circulation LVOS patients.

Increased Neutrophil-to-Lymphocyte Ratio is Associated with Unfavorable Functional Outcome in Acute Ischemic Stroke

2019 ◽  
Vol 33 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Antje Giede-Jeppe ◽  
Dominik Madžar ◽  
Jochen A. Sembill ◽  
Maximilian I. Sprügel ◽  
Selim Atay ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Neutrophil-to-lymphocyte ratio as an independent predictor for unfavorable functional outcome in aneurysmal subarachnoid hemorrhage

2020 ◽  
Vol 132 (2) ◽  
pp. 400-407 ◽  
Author(s):  
Antje Giede-Jeppe ◽  
Jonathan Reichl ◽  
Maximilian I. Sprügel ◽  
Hannes Lücking ◽  
Philip Hoelter ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Propensity Score ◽  
Functional Outcome ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Adverse Outcomes ◽  
Unfavorable Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Tertiary Center ◽  
The Impact

OBJECTIVEStroke-associated immunosuppression and inflammation are increasingly recognized as factors triggering infections and thus potentially influencing outcome after stroke. Several studies have demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes for patients with ischemic stroke or intracerebral hemorrhage. Thus far, in patients with subarachnoid hemorrhage the association between NLR and outcome is insufficiently established. The authors sought to investigate the association between NLR on admission and functional outcome in aneurysmal subarachnoid hemorrhage (aSAH).METHODSThis observational study included all consecutive aSAH patients admitted to a German tertiary center over a 5-year period (2008–2012). Data regarding patient demographics and clinical, laboratory, and in-hospital measures, as well as neuroradiological data, were retrieved from institutional databases. Functional outcome was assessed at 3 and 12 months using the modified Rankin Scale (mRS) score and categorized into favorable (mRS score 0–2) and unfavorable (mRS score 3–6). Patients’ radiological and laboratory characteristics were compared between aSAH patients with favorable and those with unfavorable outcome at 3 months. In addition, multivariate analysis was conducted to investigate parameters independently associated with favorable outcome. Receiver operating characteristic (ROC) curve analysis was undertaken to identify the best cutoff for NLR to discriminate between favorable and unfavorable outcome in these patients. To account for imbalances in baseline characteristics, propensity score matching was carried out to assess the influence of NLR on outcome measures.RESULTSOverall, 319 patients with aSAH were included. Patients with unfavorable outcome at 3 months were older, had worse clinical status on admission (Glasgow Coma Scale score and Hunt and Hess grade), greater amount of subarachnoidal and intraventricular hemorrhage (modified Fisher Scale grade and Graeb score), and higher rates of infectious complications (pneumonia and sepsis). A significantly higher NLR on admission was observed in patients with unfavorable outcome according to mRS score (median [IQR] NLR 5.8 [3.0–10.0] for mRS score 0–2 vs NLR 8.3 [4.5–12.6] for mRS score 3–6; p < 0.001). After adjustments, NLR on admission remained a significant predictor for unfavorable outcome in SAH patients (OR [95% CI] 1.014 [1.001–1.027]; p = 0.028). In ROC analysis, an NLR of 7.05 was identified as the best cutoff value to discriminate between favorable and unfavorable outcome (area under the curve = 0.614, p < 0.001, Youden’s index = 0.211; mRS score 3–6: 94/153 [61.4%] for NLR ≥ 7.05 vs 67/166 [40.4%] for NLR < 7.05; p < 0.001). Subanalysis of patients with NLR levels ≥ 7.05 vs < 7.05, performed using 2 propensity score–matched cohorts (n = 133 patients in each group), revealed an increased proportion of patients with unfavorable functional outcome at 3 months in patients with NLR ≥ 7.05 (mRS score 3–6 at 3 months: NLR ≥ 7.05 82/133 [61.7%] vs NLR < 7.05 62/133 [46.6%]; p = 0.014), yet without differences in mortality at 3 months (NLR ≥ 7.05 37/133 [27.8%] vs NLR < 7.05 27/133 [20.3%]; p = 0.131).CONCLUSIONSAmong aSAH patients, NLR represents an independent parameter associated with unfavorable functional outcome. Whether the impact of NLR on functional outcome is related to preexisting comorbidities or represents independent causal relationships in the context of stroke-associated immunosuppression should be investigated in future studies.

scholarly journals Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Stroke Severity and Short-Term Prognosis in Acute Ischemic Stroke With Intracranial Atherosclerotic Stenosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuanlin Ying ◽  
Fang Yu ◽  
Yunfang Luo ◽  
Xianjing Feng ◽  
Di Liao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stroke Severity ◽  
Short Term ◽  
Severe Stroke ◽  
Lymphocyte Ratio ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis

Background: Neutrophil-to-lymphocyte ratio (NLR) is an indicator of poor prognosis in acute ischemic stroke (AIS), but associations between NLR with stroke severity and prognosis of intracranial atherosclerotic stenosis (ICAS)-related ischemic events have not been well-elucidated; therefore, we aimed to evaluate whether admission NLR levels correlate with the early stroke severity and short-term functional prognosis in patients with symptomatic intracranial atherosclerotic stenosis (sICAS).Methods: This retrospective study enrolled 899 consecutive patients with AIS attributed to ICAS at Xiangya Hospital stroke center between May 2016 and September 2020. The initial stroke severity was rated by the admission National Institutes of Health Stroke Scale (NIHSS) scores, and the short-term prognosis was evaluated using the 14-day modified Rankin Scale (mRS) scores after stroke onset. A severe stroke was defined as NIHSS &gt;8; an unfavorable functional outcome was defined as mRS scores of 3–6. Admission NLR was determined based on circulating neutrophil and lymphocyte counts.Results: The median admission NLR of all patients was 2.80 [interquartile range (IQR), 2.00–4.00]. In univariate analysis, admission NLR was significantly elevated in patients with severe stroke and poor short-term prognosis. After multivariate adjustment, admission NLR levels were significantly correlated with severe stroke [odds ratio (OR), 1.132; 95% confidence interval (95% CI), 1.038–1.234; P = 0.005] and unfavorable short-term prognosis (OR, 1.102; 95% CI, 1.017–1.195; P = 0.018) in Model 1. In Model 2, the highest NLR tertile (≥3.533) remained an independent predictor of severe stroke (OR, 2.736; 95% CI, 1.590–4.708; P &lt; 0.001) and unfavorable functional outcome (OR, 2.165; 95% CI, 1.416–3.311; P &lt; 0.001) compared with the lowest NLR tertile (&lt;2.231). The receiver operating characteristic (ROC) curves showed the predictability of NLR regarding the stroke severity [area under the curve (AUC), 0.659; 95% CI, 0.615–0.703; P &lt; 0.001] and short-term prognosis (AUC, 0.613; 95% CI, 0.575–0.650; P &lt; 0.001). The nomograms were constructed to create the predictive models of the severity and short-term outcome of sICAS.Conclusions: Elevated admission NLR levels were independently associated with the initial stroke severity and could be an early predictor of severity and poor short-term prognosis in AIS patients with ICAS, which might help us identify a target group timely for preventive therapies.

scholarly journals Prognostic value of neutrophil to lymphocyte ratio in acute ischemic stroke after reperfusion therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ying Bi ◽  
Jing Shen ◽  
Sheng-Cai Chen ◽  
Ji-Xiang Chen ◽  
Yuan-Peng Xia
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Meta Analysis ◽  
Credible Interval ◽  
Reperfusion Therapy ◽  
Neutrophil To Lymphocyte Ratio ◽  
Categorical Variables ◽  
Poor Functional Outcome ◽  
Lymphocyte Ratio

AbstractThe purpose of this study was to investigate whether baseline neutrophil to lymphocyte ratio (NLR) was an independent predictor for early symptomatic intracranial hemorrhage (sICH), poor functional outcome and mortality at 3 months after reperfusion therapy in acute ischemic stroke (AIS) patients. Using PubMed and EMBASE, we searched for literature published before January 19th, 2019. Two reviewers independently confirmed each study’s eligibility, assessed risk of bias, and extracted data. One reviewer combined studies using random effects meta-analysis. 9 studies with 3651 patients were pooled in the meta-analysis. Overall, baseline NLR levels were greater in patients with poor outcome. The standardized mean difference (SMD) in the NLR levels between patients with poor functional outcome (mRS > 2) and good functional outcome (mRS ≤ 2) was 0.54 units (95% credible interval [CI] [0.38, 0.70]). Heterogeneity test showed that there were significant differences between individual studies (p = 0.02; I2 = 72.8%). The NLR levels were associated with sICH in four included studies (n = 2003, SMD = 0.78, 95% [CI] [0.18, 1.38], I2 = 73.9%). Higher NLR levels were positively correlated with 3-month mortality (n = 1389, ES = 1.71, 95% CI [1.01,2.42], p < 0.01, I2 = 0%) when data were used as categorical variables. Our meta-analysis suggests that increased NLR levels are positively associated with greater risk of sICH, 3-month poor functional outcome and 3-month mortality in AIS patients undergoing reperfusion treatments. Although there are some deficits in this study, it may be feasible to predict the prognosis of reperfusion therapy in AIS patients with NLR levels.

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