NEUTROPHIL-TO-LYMPHOCYTE RATIO AND PLATELET-TO-LYMPHOCYTE RATIO AS FACTORS TO PREDICT IN HOSPITAL MORTALITY IN ACUTE ISCHEMIC STROKE
Background and Aims
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as independent prognostic markers in stroke. The aim of this study was to investigate the predictive role of the NLR and PLR at admission in patients with acute ischemic stroke.
This study included 3,107 consecutive patients who were admitted to Korea University Anam Hospital for acute ischemic stroke. NLR and PLR were calculated from the differential counts of leukocytes and platelet counts drawn at admission. Primary endpoint was mortality during hospitalization.
The mean age of 3,107 patients was 67.9 years and 59.1% were male. A total of 66 (2.1%) patients died during hospitalization. The NLR of the deceased were higher than the survivors (6.19 vs 3.56 p=0.001). PLR showed similar pattern without statistical significance (166.79 vs 139.21, p=0.135). Receiver operating characteristics (ROC) curve analysis revealed that the NLR 3.82 (AUC: 0.662) and PLR 216.67 (AUC: 0.534) were the most powerful predictor of in-hospital mortality, respectively. The mortality rate of patients with both NLR and PLR values above cut-off value was significantly higher (4.8% vs 1.8%, p=0.001). Binary logistic regression analysis also support this finding with statistical significance (p=0.019).
Higher values of both NLR and PLR were independently associated with in-hospital mortality with the advantage of being inexpensive and readily available.