Neutrophil to lymphocyte ratio predicts hemorrhagic transformation in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2021.08.005
- VernacularTitle:中性粒细胞/淋巴细胞比值预测急性缺血性卒中患者的出血性转化
- Author:
Wenya LAN
1
;
Feng QIU
;
Yao ZHANG
;
Haibo JIANG
;
Mingyang DU
;
Lili XU
;
Hui CAO
Author Information
1. 南京医科大学附属脑科医院 210029
- Keywords:
Stroke;
Brain ischemia;
Intracranial hemorrhage;
Neutrophils;
Lymphocytes;
Risk factors;
Predictive value of tests
- From:
International Journal of Cerebrovascular Diseases
2021;29(8):583-588
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) for hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS).Methods:Consecutive patients with AIS without performing intravenous thrombolysis and mechanical thrombectomy admitted to the Cerebrovascular Disease Treatment Center, the Affiliated Brain Hospital of Nanjing Medical University from December 2015 to December 2020 were enrolled. The clinical, imaging and laboratory examination data were collected. HT was defined as the first imaging examination of AIS patients without finding bleeding signs, but the imaging reexamination after hospitalization found intracranial hemorrhage. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and HT. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT. Results:A total of 805 patients with AIS were included. The median age was 67 years (interquartile range, 63-71 years), the median National Institutes of Health Stroke Scale (NIHSS) score was 4 (interquartile range, 2-9), the median NLR was 3.84 (interquartile range, 2.66-5.30). Seventy-ywo patients (8.9%) had HT. There were significant differences in age, baseline systolic blood pressure, baseline NIHSS score, time from onset to admission, time from onset to blood collection, time from onset to imaging reexamination, NLR, atrial fibrillation, history of previous stroke and transient ischemic attack and stroke etiology between the HT group and the non-HT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for HT in patients with AIS after adjusting for confounding factors (odds ratio 1.355, 95% confidence interval 1.099-1.672; P=0.005). The ROC curve analysis showed that the area under the curve of NLR predicting HT was 0.852, and the optimal cut-off value was 4.75. Its sensitivity and specificity of predicting HT were 88.3% and 71.8% respectively. Conclusion:High NLR is an independent risk factor for HT in patients with AIS during hospitalization, and had better predictive value for HT risk.
