Impact of Neutrophil-to-Lymphocyte Ratio on Stroke Severity and Clinical Outcome in Anterior Circulation Large Vessel Occlusion Stroke

<b>Background:</b> The prognostic value of the neutrophil-lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. <b>Methods:</b> A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. <b>Results:</b> Admission NLR correlated weakly but significantly with both baseline (<i>p</i> = 0.018) and 24 h (<i>p</i> = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, <i>p</i> = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, <i>p</i> = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (<i>p</i> = 0.557). <b>Conclusions:</b> Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

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Publication Details

Journal
Diagnostics
Published
2024-12-21
DOI
https://doi.org/10.3390/diagnostics14242880
Citations
4
Primary Topic
Acute Ischemic Stroke Management
Type
article
Field-Weighted Citation Impact
1.55
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article

Impact of Neutrophil-to-Lymphocyte Ratio on Stroke Severity and Clinical Outcome in Anterior Circulation Large Vessel Occlusion Stroke

Ferhat Balgetir, Ebru Temel, Talip Asıl, Murat Çabalar et al.
4 citations
Diagnostics
Acute Ischemic Stroke Management
1.55
article

Impact of Neutrophil-to-Lymphocyte Ratio on Stroke Severity and Clinical Outcome in Anterior Circulation Large Vessel Occlusion Stroke

Ferhat Balgetir, Ebru Temel, Talip Asıl, Murat Çabalar, Utku Cenikli, Nazım Kızıldağ, Eşref Akıl, Alper Eren, Ayşenur Önalan, Zaur Mehdiyev, Recep Baydemir, Özlem Aykaç, Serhan Yıldırım, Ümit Görgülü, Emine Saygın Uysal, Türkan Acar, Ahmet Yabalak, Şennur Delibaş Katı, Fettah Eren, Hamza Gültekin, Erdem Gürkaş, Ayça Özkul, Muhammed Nur Öğün, Bilgehan Atılgan Acar, Çetin Kürşad Akpınar, Mehmet Semih Arı, Zehra Uysal Kocabaş, Sena Boncuk Ulaş, Zülfikar Memiş, Mustafa Çeti̇ner, Aysel Büşra Şişman Bayar, Alihan Abdullah Akbaş, Atilla Özcan Özdemir, Hasan Doğan, Emrah Aytaç, Cebrail Durmaz, Hasan Bayındır
article en
4 citations

Abstract

<b>Background:</b> The prognostic value of the neutrophil-lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. <b>Methods:</b> A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. <b>Results:</b> Admission NLR correlated weakly but significantly with both baseline (<i>p</i> = 0.018) and 24 h (<i>p</i> = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, <i>p</i> = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, <i>p</i> = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (<i>p</i> = 0.557). <b>Conclusions:</b> Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

DiagnosticsVol. 14(24)
Sakarya University (TR), Dicle University (TR), Selçuk University (TR), Fırat University (TR), Bilkent University (TR), Memorial Ankara Hospital (TR), Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi (TR), Biruni University (TR), Istanbul Metropolitan Municipality (TR), Haseki Eğitim ve Araştırma Hastanesi (TR), Diyarbakır Askeri Hastanesi (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Samsun University (TR), Sağlık Bilimleri Üniversitesi (TR), Kutahya Saglik Bilimleri Universitesi, Ankara Bilkent City Hospital (TR), Eskişehir Osmangazi University (TR), Kocaeli Üniversitesi (TR), Düzce Üniversitesi (TR), Atatürk University (TR), Bolu Abant İzzet Baysal University (TR), Muğla University (TR), Erciyes University (TR)
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Openalex Percentile: Top 15%
Acute Ischemic Stroke Management
1.55
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