scholarly journals Increased Neutrophil-To-Lymphocyte Ratio After Thrombolysis Improves Prediction of 3-Month Stroke Outcome

2021 ◽  
Author(s):  
Duanlu Hou ◽  
Chunjie Wang ◽  
Xiaofei Ye ◽  
Ping Zhong ◽  
Danhong Wu
Keyword(s):  
Functional Outcomes ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Blood Perfusion ◽  
Multivariate Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Before And After ◽  
Patient Groups

Abstract Objectives-Thrombolysis is the effective therapy for acute ischemic stroke (AIS) within 4.5 hours of onset. It improves prognosis by increasing blood perfusion to the lesion. Though inflammation is a predictor of 3-month outcomes after thrombolysis, the temporal effect of thrombolysis on inflammation and the correlation between inflammation after thrombolysis and patients’ prognosis remain to be elucidated. Materials and Methods-Demographic, clinical, laboratory data before and after thrombolysis, and 3-month mRS scores were collected and compared. The neutrophil-to-lymphocyte ratio (NLR) was divided into low and high NLR subgroups and functional outcomes at 3 months were compared. Multivariate regression analysis was used to test independent predictors of 3-month prognosis. Results- 493 patients with AIS were prospectively enrolled between 1st August, 2017 and 1st September, 2019. 170 received thrombolysis and 323 patients did not. The NLR after thrombolysis was higher than that before thrombolysis among patients who received thrombolysis (p<0.001) and higher than that of patients who did not receive thrombolysis (p<0.001). The NLR after thrombolysis was an independent predictor of 3-month functional outcomes (OR =1.20, 95% CI: 1.01-1.42, p=0.03). The best discriminating value for the NLR is 4.51 (sensitivity 65.7%, specificity 73.1%, AUC: 0.85; 95% CI: 0.77-0.92). Significant difference (62% vs 88%, p<0.001) was observed in the patients with good 3-month outcome between patient groups with the NLR>4.51 and <4.51, respectively. Conclusions-NLR increase after thrombolysis was a predictor of poor 3-month functional outcome in AIS patients.

scholarly journals Increased neutrophil-to-lymphocyte ratio after thrombolysis better predicts 3-month stroke outcome

2020 ◽  
Author(s):  
Duanlu Hou ◽  
Chunjie Wang ◽  
Xiaofei Ye ◽  
Ping Zhong ◽  
Danhong Wu
Keyword(s):  
Cerebral Infarction ◽  
Functional Outcome ◽  
Characteristic Curve ◽  
Laboratory Data ◽  
Multivariate Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Unique Identifier ◽  
Clinical Trial Registration ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Background-Thrombolysis has become an effective therapy for acute cerebral infarction (AIS) within 4.5 hours. Thrombolysis improves prognosis by increasing perfusion of the ischemic penumbra. Inflammation as one of the mechanisms of cerebral infarction, the role of thrombolysis is the topic of our exploration. Methods-From August 1, 2017 and September 1, 2019, 493 consecutive patients with AIS were prospectively enrolled in this cohort. 170 patients received thrombolytic therapy and 323 patients did not have thrombolysis. Clinical evaluation, laboratory data before and after thrombolysis and 3-month modified Rankin scale (mRS) scores were compared. Neutrophil-to-lymphocyte ratio (NLR), which represents inflammatory response, was divided into quartiles for comparison. Multivariate regression analysis was used to determine independent factors of 3-month prognosis. The receiver operating characteristic curve was used to evaluate the predictability of NLR for good prognosis that was defined as 3-month mRS scores < 3. Results-The NLR after thrombolysis was higher than that before thrombolysis (p < 0.001) and in non-thrombolytic patients (p < 0.001). NLR after thrombolysis is an independent predictor of 3-month functional outcome (odds ratio (OR) = 1.20, 95% confidence interval (CI), 1.01–1.42, p = 0.03). Also, a cutoff value of 4.51 for NLR was detected in predicting post-thrombolysis 3-month functional outcome with a sensitivity of 65.7% and a specificity of 73.1% (area under curve [AUC], 0.85; 95% CI, 0.77–0.92). We also found a significant difference (62% vs 88%, p < 0.001) in the proportion of good 3 months prognosis between the higher and lower group. Conclusions-This study showed that NLR increase after thrombolysis better predict post-thrombolytic unfavorable functional outcome in AIS patients. Clinical Trial Registration-URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800018315. URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800019615.

scholarly journals Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Patients With Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuki Kuranari ◽  
Ryota Tamura ◽  
Noboru Tsuda ◽  
Kenzo Kosugi ◽  
Yukina Morimoto ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Laboratory Data ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Tumor Location ◽  
Neutrophil To Lymphocyte Ratio ◽  
Ki 67 ◽  
Who Grade ◽  
Lymphocyte Ratio ◽  
Subtotal Removal

BackgroundMeningiomas are the most common benign intracranial tumors. However, even WHO grade I meningiomas occasionally show local tumor recurrence. Prognostic factors for meningiomas have not been fully established. Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic factor for several solid tumors. The prognostic value of NLR in meningiomas has been analyzed in few studies.Materials and MethodsThis retrospective study included 160 patients who underwent surgery for meningiomas between October 2010 and September 2017. We analyzed the associations between patients’ clinical data (sex, age, primary/recurrent, WHO grade, extent of removal, tumor location, peritumoral brain edema, and preoperative laboratory data) and clinical outcomes, including recurrence and progression-free survival (PFS).ResultsForty-four meningiomas recurred within the follow-up period of 3.8 years. WHO grade II, III, subtotal removal, history of recurrence, Ki-67 labeling index ≥3.0, and preoperative NLR value ≥2.6 were significantly associated with shorter PFS (P &lt; 0.001, &lt; 0.001, 0.002, &lt; 0.001, and 0.015, respectively). Furthermore, NLR ≥ 2.6 was also significantly associated with shorter PFS in a subgroup analysis of WHO grade I meningiomas (P = 0.003). In univariate and multivariate analyses, NLR ≥2.6 remained as a significant predictive factor for shorter PFS in patients with meningioma (P = 0.014).ConclusionsNLR may be a cost-effective and novel preoperatively usable biomarker in patients with meningiomas.

scholarly journals AB0655 RHEUMATOID ARTHRITIS ACTIVITY BEFORE AND AFTER COVID-19 LOCKDOWN PERIOD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1360.1-1360
Author(s):  
M. Jordhani ◽  
D. Ruci ◽  
F. Skana ◽  
E. Memlika
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Musculoskeletal Diseases ◽  
Statistical Tests ◽  
Laboratory Data ◽  
World Population ◽  
Chronic Patients ◽  
Das 28 ◽  
Significant Difference ◽  
Before And After

Background:The COVID-19 global pandemic has had a great impact on world population due to morbidity, mortality and restriction measures in order to stop the progression of COVID-19.Patients with rheumatic and musculoskeletic diseases, and especially rheumatoid arthritis (RA) patients, being one of the vulnerable classes of chronic patients, were recommended to follow the government’s rules1.Objectives:The aim of this study was to evaluate DAS-28-ESR in patients with rheumatoid arthritis before and after lockdown period.Methods:This is a multi-center observational study including 85 patients which were evaluated before and after lockdown for their disease activity score according to DAS-28-ESR score. They had been diagnosed with rheumatoid arthritis more than 5 years ago. A thorough physical examination was performed before and after the lockdown period. It included examination of tender and swollen joints and patient’s global health. They were completed with all required laboratory data, including erythrosedimentation rate. For a more accurate calculation, DAS-28-ESR was used in an electronic version. Patients with other inflammatory or infective diseases were excluded from the study. All data were statistically evaluated using statistical tests such as t-student test.Results:The first group (the one before lockdown) had an average DAS-28-ESR of 4.7 while after the lockdown period, the average DAS-28-ESR was 5.16.After statistically evaluating all data, it was found that there exists a significant difference between DAS-28-ESR score before and after COVID-19 lockdown (p=0.0011).Conclusion:Our study showed that lockdown period due to COVID-19 pandemic, has aggravated disease activity in patients with Rheumatoid Arthritis. This may be consequence of various causes such as physical inactivity and difficulty to follow-up or to take the medication properly.References:[1]Landewé RB, Machado PM, Kroon F, et al, EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2, Annals of the Rheumatic Diseases 2020;79:851-858.Disclosure of Interests:None declared.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

The association between neutrophil-to-lymphocyte ratio and contrast-induced acute kidney injury in patients with carotid artery stenting

Vascular ◽  
2021 ◽  
pp. 170853812110125
Author(s):  
Altuğ Ösken ◽  
Ahmet Öz ◽  
Muhammed Keskin ◽  
Evliya Akdeniz ◽  
Hasan Şahan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Kidney Injury ◽  
Fold Increase ◽  
Multivariate Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
Prolonged Hospital

Objectives Contrast-induced acute kidney injury (CI-AKI) is a life-threatening complication that leads to comorbidities and prolonged hospital stay lengths in the setting of peripheral interventions. The presence of some CI-AKI risk factors has already been investigated. In this study, we evaluated the predictors of CI-AKI after carotid artery stenting. Methods A total of 389 patients with 50% to 99% carotid artery stenosis who underwent carotid artery stenting were included in this study. Patients were grouped according to CI-AKI status. Results CI-AKI developed in 26 (6.6%) patients. Age, baseline creatinine level, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were higher and estimated glomerular filtration rate, haemoglobin and lymphocyte count were lower in CI-AKI patients. In the multivariate regression analysis, the neutrophil-to-lymphocyte ratio triggered a 1.39- to 2.63-fold increase in the risk of CI-AKI onset ( p < 0.001). Conclusions The neutrophil-to-lymphocyte ratio may be a significant predictor of CI-AKI in patients with carotid artery stenting and higher neutrophil-to-lymphocyte ratio values may be independently associated with CI-AKI.

Predictive value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for primary patency of percutaneous transluminal angioplasty in hemodialysis arteriovenous fistula stenosis

Vascular ◽  
2021 ◽  
pp. 170853812110396
Author(s):  
Feng Zhu ◽  
Yao Yao ◽  
Hongbo Ci ◽  
Alimujiang Shawuti
Keyword(s):  
Arteriovenous Fistula ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Percutaneous Transluminal ◽  
Hemodialysis Arteriovenous Fistula

Objective The aim of this study is to investigate the potential association of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with the primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula (AVF) stenosis. Methods This study conducted a retrospective review of patients with end-stage renal disease referred for hemodialysis AVF stenosis in one center. The study consisted of 114 patients with significant (significant stenosis was defined as a reduction in the caliber of the fistula vein of > 50% with respect to the non-aneurysmal venous segment). AVF stenosis patients were treated with PTA, with conventional balloon angioplasty. The NLR and PLR were calculated from the pre-interventional blood samples. The patients were classified into two groups: group A, primary patency < 12 months ( n = 35) and group B, and primary patency ≥ 12 months ( n = 79). Comparisons between the groups were performed using the Mann–Whitney U test. Kaplan–Meier analysis was performed to compare the factors, NLR and PLR, for association with primary patency AVFs. A receiver-operating characteristic curve analysis was performed to identify the sensitivity and specificity of the NLR and PLR cut-off values in the prediction of primary patency time. Results There was no difference in gender; age; side of AVF; AVF type; comorbid diseases such as diabetes mellitus and hypertension; or blood parameters such as white cell count, erythrocytes, hemoglobin, neutrophils, lymphocytes, monocytes, eosinophils, basophils, C-reactive protein, NLR, or PLR between the two groups ( p > 0.05). There was also no significant difference in the patency rate between the NLR < 4.13 and NLR ≥ 4.13 groups at 12 months (NLR cut-off point = 4.13, p = 0.273). There were statistically significant differences between the primary patency rates of the PLR < 187.86 and PLR ≥ 187.86 groups at 12 months (PLR cut-off point = 187.86, p = 0.023). The cut-off value for PLR for the determination of primary patency was 187.86, with a sensitivity of 57.0% and specificity of 34.4%. Conclusion An increased level of PLR may be a risk factor for the development of early AVF restenosis after successful PTA. However, more studies are needed to validate this finding.

scholarly journals Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Eren Pek ◽  
Fatma Beyazit ◽  
Nilay Sen Korkmaz
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Inflammatory Marker ◽  
Diagnostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Cross Sectional ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Significant Difference

Objectives: This study was conducted to evaluate the diagnostic value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in vaginitis patients. Methods: This cross-sectional retrospective study was performed in Afyon Dinar State Hospital between July 2016 to August 2017. A total of 64 bacterial vaginosis (BV) patients, 66 vulvovaginal candidiasis (VVC) patients and 65 age-matched control subjects were enrolled. NLR, PLR, mean platelet volume (MPV), red cell distribution width (RDW) and other conventional inflammatory marker values were recorded for all patients before and after treatment. Results: In the BV group, NLR values were found to be elevated compared to VVC and healthy controls [2.9 (1.2-14.7), 2.1 (1.1-11.7) and 2.1 (0.8-7.0), respectively] (p=0.008). Although not found to be statistically significant, the median NLR levels of BV patients decreased from 2.9 (1.2-14.7) to 2.4 (1.2-7.0) after treatment. PLR levels did not show a statistically significant difference between the three groups (p=0.970). The cut-off value of the NLR for BV was 2.19, with 67.2% sensitivity and 63.8% specificity. Conclusions: The present study demonstrated that NLR levels are elevated in bacterial vaginosis and NLR levels can be used as a reflection of systemic inflammatory response in vaginosis patients. doi: https://doi.org/10.12669/pjms.37.1.2774 How to cite this:Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pak J Med Sci. 2021;37(1):250-255. doi: https://doi.org/10.12669/pjms.37.1.2774 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

2019 ◽  
Vol 65 (3) ◽  
pp. 91-96
Author(s):  
Claudia Floriana Suciu ◽  
Andreea Varga ◽  
Corneliu Florin Buicu ◽  
Ioan Tilea
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aortic Arch ◽  
Laboratory Data ◽  
Hypertensive Heart Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Advanced Chronic Kidney Disease ◽  
Hypertensive Patients ◽  
Lymphocyte Ratio ◽  
Aortic Arch Calcification

AbstractObjective: Our study aimed to validate the neutrophil-to-lymphocyte ratio (NLR) as a marker for aortic arch calcification in hypertensive patients with less advanced chronic kidney disease (CKD).Methods: A number of forty-four hypertensive patients with chronic kidney disease (categories G3a and G3b – 2012 KDIGO nomenclature) were included in the study. Considering the presence of aortic arch calcification (AAC) on chest X-ray, the study population was divided into two groups: 27 patients AAC present and seventeen without aortic arch calcification. Laboratory data were collected for each patient and NLR was computed. Comorbidities were also recorded: stable coronary artery disease, lower extremity arterial disease and hypertensive heart disease.Results: A positive correlation between neutrophil-to-lymphocyte ratio and aortic arch calcification in hypertensive CKD patients was identified. Furthermore, advanced age, increased alkaline phosphatase and increased erythrocyte sedimentation rate had a positive association with aortic arch calcification. We found no statistical correlation between neutrophil-to-lymphocyte ratio and other laboratory features in both groups of patients.Conclusions: Neutrophil-to-lymphocyte ratio may be viewed as a potential risk factor for vascular calcification in patients with moderate chronic kidney disease; nevertheless, future extensive studies are necessary. In the management of hypertensive patients, general medicine might particularly benefit of this simple, readily available inflammatory marker.

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