Neutrophil-lymphocyte Ratio may be an Early Predictor of the Prognosis in Ischemic Stroke Cases

Gülsüm Çomruk1, Yasemin Ekmekyapar Fırat2, Sırma Geyik3, Emine Kılıçparlar Cengiz4, Ayşe Münife Neyal2

1Hatay State Hospital, Clinic of Neurology, Hatay, Turkey
2Sanko University Faculty of Medicine, Department of Neurology, Gaziantep, Turkey
3Gaziantep University Faculty of Medicine, Department of Neurology, Gaziantep, Turkey
4Dr. Ersin Arslan Training and Research Hospital, Clinic of Neurology, Gaziantep, Turkey

Keywords: Neutrophil-lymphocyte ratio, ischemic stroke, prognosis

Abstract

Objective: Prognostic predictors in the very early period of acute stroke are still needed. Neutrophil-lymphocyte ratio (NLR) was reported as a useful prognostic indicator for vascular diseases. However, its’ time-related changes are not sufficiently studied. In the present study, we aimed to investigate if the NLR at the first day of hospitalization is associated with some clinical and laboratory findings in patients with ischemic stroke and if they change in the following days.

Materials and Methods: The hospital data of 80 consecutive acute ischemic stroke patients were retrospectively documented and evaluated. NLR values that were calculated twice; on the day of admission and at least five days later, were compared to check if there are any significant changes. Since the study was conducted as a retrospective registry analysis, consent was not obtained from the patients.

Results: NLR ratios were similar in the two follow-up blood samples (p=0.873). In the evaluation according to stroke severity; the NLR cut-off point on the day of admission was 2.86 (sensitivity 88.9%, specificity 72.6%). This cut-off value showed a higher sensitivity and specificity in the cases who did not have an infection during hospital stay (sensitivity 100%, specificity 83%). Age, leukocyte and thrombocyte counts, risk of hospital infection and duration of hospital stay were significantly lower in the cases with NLR <2.9 than those with NLR ≥2.9.

Conclusion: NLR calculated on the first day of admission can be useful and adequate for assessing the severity of stroke, predicting the length of hospital stay and the risk of infection during hospitalization.

Ethics Committee Approval

Approval for the study was obtained from Gaziantep University Clinical Research Ethics Committee with the decision number 07.06.2015/201 on 07.05.15.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept: G.Ç., A.M.N., Design: G.Ç., Y.E.F., A.M.N., Data Collection or Processing: G.Ç., Y.E.F., S.G., E.K.C., A.M.N., Analysis or Interpretation: G.Ç., Y.E.F., S.G., E.K.C., A.M.N., Literature Search: G.Ç., Y.E.F., A.M.N., Writing G.Ç., A.M.N.

Conflict of Interest

No conflict of interest was declared by the authors.

Financial Disclosure

The authors declared that this study received no financial support.