Neutrophil/lymphocyte ratio predicts discharge outcome in elderly patients with acute ischemic stroke receiving intravenous thrombolytic therapy
10.3760/cma.j.issn.1673-4165.2023.12.002
- VernacularTitle:中性粒细胞/淋巴细胞比值预测接受静脉溶栓治疗的老年急性缺血性卒中患者的出院转归
- Author:
Yafang ZHU
1
;
Shoujiang YOU
;
Xia ZHANG
;
Yan QIN
;
Fengmei TIAN
;
Liping TAN
;
Yongjun CAO
;
Dongqin CHEN
Author Information
1. 苏州大学附属第二医院神经内科，苏州 215004
- Keywords:
Ischemic stroke;
Thrombolytic therapy;
Neutrophils;
Lymphocytes;
Treatment outcome;
Intracranial hemorrhages;
Predictive value of tests;
Elderly
- From:
International Journal of Cerebrovascular Diseases
2023;31(12):889-894
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) on the discharge outcome in elderly patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT).Methods:Elderly patients with AIS received IVT in the Department of Neurology, the Second Affiliated Hospital of Soochow University from August 2018 to August 2020 were retrospectively included. The modified Rankin Scale was used to evaluate discharge outcome, and the score >2 was defined as poor outcome. Symptomatic intracranial hemorrhage (sICH) was defined as any intracranial hemorrhage found on imaging examination accompanied by neurological deterioration, where the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 from baseline or bleeding led to death. Multivariate logistic regression analysis was used to determine independent risk factors for sICH and poor discharge outcome. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of NLR for sICH and poor discharge outcome. Results:A total of 228 elderly patients with AIS receiving IVT were enrolled, including 118 males (51.8%), aged 73.64±8.16 years, with a baseline NIHSS score of 6.23±6.54. Ninety patients (39.5%) had poor outcome at discharge, and 16 (7.0%) developed sICH. Univariate analysis showed that the NLR in the poor outcome group was significantly higher than that in the good outcome group ( P<0.01). Multivariate logistic regression analysis showed that a higher NLR was an independent risk factor for poor discharge outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.044-1.484; P< 0.05) and sICH ( OR 1.124, 95% CI 1.010-1.251; P<0.05). ROC curve analysis showed that the area under the curve of NLR for predicting poor discharge outcome was 0.693 (95% CI 0.620-0.765; P<0.01). The optimal cutoff value was 4.345. Its corresponding sensitivity and specificity were 47.8% and 87.7%, respectively. The area under the curve of NLR for predicting sICH was 0.651 (95% CI 0.498-0.804; P<0.05). The optimal cutoff value was 3.515. Its corresponding sensitivity and specificity were 68.8% and 61.8%, respectively. Conclusions:A higher NLR is independently associated with sICH and poor discharge outcome in elderly patients with AIS receiving IVT, and have certain predictive value for sICH and poor discharge outcome.
