Neutrophil Lymphocyte Ratio as a Predictor of Short-term Mortality in Acute Ischaemic Stroke

Background: Acute ischaemic stroke (AIS) is a leading cause of mortality and disability worldwide, with early mortality being a critical concern. Inflammation plays a pivotal role in the pathophysiology of AIS, influencing outcomes. The neutrophil-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has emerged as a potential predictor of stroke prognosis. This study aimed to evaluate the role of NLR in predicting short-term mortality among AIS patients. Methods: This prospective study was conducted in the Department of Medicine & Department of Neurology in Dhaka Medical College Hospital, Dhaka, Bangladesh from February 2018 to July 2018. A total of 384 participants suffering from acute ischaemic stroke (AIS) who were admitted to the hospital within 24 hours of onset were enrolled as the study subjects purposively. Data were analyzed using SPSS version 23.0. Results: In this study of 100 acute ischaemic stroke patients, the mean age was 60.71±11.19 years. Eighteen percent of patients died within 30 days’ post-stroke. Mortality was significantly associated with higher WBC, neutrophil count, NLR, RBS, and TG, and lower lymphocyte count (p<0.05). Logistic regression analysis showed that each unit increase in NLR, along with hypertension, diabetes, and dyslipidemia, significantly increased the odds of 30-day mortality (p<0.05). Conclusion: In acute ischaemic stroke patients, an elevated neutrophil lymphocyte ratio (NLR) is a significant predictor of 30-day mortality. NLR, along with comorbidities such as hypertension, diabetes, and dyslipidemia, can help identify high-risk patients for better management.