Neutrophil to lymphocyte ratio and early clinical outcomes in patients with acute ischemic stroke

Abstract

Background: The neutrophil to lymphocyte ratio (NLR) is closely linked to mortality in patients with cardiovascular disease. We investigated whether NLR is associated with early clinical outcomes in patients with acute ischemic stroke. Methods: We collated data from a tertiary hospital's stroke registry including admitted patients with a first-ever acute ischemic stroke within 72 h of onset. White blood cell counts and peripheral differential counts were measured on admission. Early clinical outcomes were in-hospital mortality and disability at discharge assessed by the modified Rankin scale (mRS). Results: Among 1131 stroke patients, 454 patients were included and classified into tertile groups based on NLR on admission. Patients in higher tertiles of NLR were likely to have severe neurologic deficit at discharge. Higher NLR tertiles were associated with an unfavourable shift of mRS score (p <.0001). This association remained significant after adjustment for clinical and laboratory variables including age, sex, hypertension, hypercholesterolemia, atrial fibrillation, stroke severity, and glucose level (p =.032 for trend). However, risk of death or major disability (score of 3-6 on mRS) and in-hospital mortality were not significantly different across NLR tertile groups. Conclusions: In patients with acute ischemic stroke, NLR was predictive of short-term functional outcome.