scholarly journals The Predictive Effect of the Neutrophil-to-Lymphocyte Ratio (NLR) on the Mortality of Acute Ischemic Stroke and its Subtypes: a Retrospective Cross-Sectional Study

2016 ◽  
Vol 15 (2) ◽  
pp. 69-72 ◽  
Author(s):  
Ugur Lok ◽  
Umut Gulacti
Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rizky Sarengat ◽  
Mohammad S. Islam ◽  
Mohammad S. Ardhi

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.


2019 ◽  
Vol 26 (6) ◽  
pp. 55-66
Author(s):  
Khairol Ashraf Ahmad ◽  
◽  
Noorharisman Ideris ◽  
Syed Hassan Syed Abd Aziz ◽  
◽  
...  

Background: Inflammation plays a role in the pathophysiology of cerebral ischemic and also an initial response to brain injury. Inflammation involving Blood and Brain Barrier disturbance, leukocyte infiltration, endothelial cells activation, oxidant and inflammatory mediator buildups which can develop rapidly within hours and can cause secondary injury to brain tissues Objectives: To determine the correlation between Neutrophil-to-Lymphocyte Ratio (NLR) and High Sensitivity C Reactive Protein (hsCRP) with severity and outcome in acute ischemic stroke patients Methods: This study used a cross-sectional design approach. Sampling was done at H. Adam Malik General Hospital Medan and taken as many as 38 subjects. NLR and hsCRP were examined on the first day of admission. Severity was assessed by using the National Institutes of Health Stroke Scale and the outcome was assessed by using the Modified Ranking Scale on the first and fourteenth day of admission. The data analysis used the contingency coefficient correlation test and gamma test. Results: Demographic characteristics of the subjects are; the average age is 62 years old, the highest educational level is high school graduate, and the most occupation is unemployed. There is a positive, moderate, and significant correlation between NLR and severity of acute ischemic stroke (r=0.511; p=0.001). There is a positive, moderate, and significant correlation between NLR and the outcome of acute ischemic stroke (r=0.463; p=0.001). There is a positive, very strong, and significant correlation between hsCRP and severity of acute ischemic stroke (r=0.896; p=0.001). There is a positive, strong, and significant correlation between hsCRP and outcome of acute ischemic stroke (r=0.624; p=0.001) Conclusions: There is a positive and significant correlation between NLR and hsCRP with severity and outcome in acute ischemic stroke patients.


2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.


2020 ◽  
Author(s):  
Hong Shen ◽  
Xia Zhou ◽  
Xiaolan Wang ◽  
Rui Li ◽  
Ying Xiao ◽  
...  

Abstract Background There are some conflicting results regarding the neutrophil-to-lymphocyte ratio (NLR) and the severity of disease in patients with schizophrenia. Inconsistent findings among the studies might be caused by several limitations, such as, heterogeneous patient populations lacking stratification by antipsychotic therapy, small sample sizes lacking statistical power, ignoring multicollinearity between NLR and other related factors, and lack of controlling for potential confounding factors. In this study, we evaluated the possible correlation between NLR and disease severity as manifested in clinical scores in patients with schizophrenia. In particular, NLR is correlated with discrepant psychiatric symptoms in the different status of antipsychotic medication administration. Methods This was a cross-sectional study conducted in our hospital. We identified inpatients with schizophrenia between July 12, 2018 and March 27, 2019 and who had NLR, Clinical Global Impression Severity scale (CGIS) and Brief Psychiatric Rating Scale (BPRS) scores. Results The records of 1144 identified patients (32.4% male, 76.6% with NLR ≤ 1.98, and 10.8% drug-free patients) were analyzed. Multivariate logistic regression showed that NLR was positively associated with worse psychiatric symptoms, both the CGIS score (moderately ill: OR: 63.578, p = 0.011; severely ill: OR: 53.617, p = 0.015) and the BPRS total score (moderately ill: OR: 4.049, p = 0.055; severely ill: OR: 4.312, p = 0.045). In the drug-therapy subgroup, there was a negative correlation between NLR and severe negative symptoms (severely ill: OR: 0.850, p = 0.018) after controlling for potential confounding factors. Conclusions The study is the first to confirm the hypothesis that NLR is independently associated with severe psychopathology in schizophrenia. There is the different correlation between NLR and psychiatric symptoms in the different status of antipsychotic therapy. Therefore, NLR is not appropriate to be an inflammatory biomarker for assessment of disease severity, but provide potential mechanistic insights on specific pathological cellular processes, as well be a potential target to improve the course of the psychotic disorder.


2020 ◽  
Vol 7 (9) ◽  
pp. 1307
Author(s):  
Mohammed Alqwaifly

Background: Stroke is a major cause of morbidity and disability worldwide. However, its outcomes have improved in the last few years with advancement in acute stroke treatment, including the use of tissue plasminogen activator (t-PA) within 4.5 hours of onset, which led several international guidelines to adopt it as the standard of care. In this study, authors sought to assess the knowledge, practices, and attitudes of emergency and medicine staff in Qassim, Saudi Arabia toward acute ischemic stroke care.Methods: A quantitative observational cross-sectional study involving 148 physicians from emergency and medicine departments (only three neurologists) was conducted in three main hospitals of the Qassim region, Saudi Arabia. Information was obtained from a self-administered questionnaire. A logistic regression model was used to control for potential confounding factors.Results: Ninety-two percent of participants were aware of t-PA. Eighty-seven percent of participants thought that t-PA was an effective treatment for acute ischemic stroke. Only 20% of participants had given t-PA or participated in the use of t-PA in acute ischemic stroke. Moreover, 64% of participants believed that allowing blood pressure to remain high was the most appropriate action in the first 24 hours in acute ischemic stroke patients who presented outside the t-PA window.Conclusion: Most of the emergency and medicine staff are well informed about t-PA, but the majority of these physicians have never given t-PA or participated in the administration of t-PA to a stroke patient. The main finding here is the positive outlook among emergency and medicine physicians in Qassim toward training in acute stroke care and administering t-PA for stroke, which will positively impact patient outcomes.


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