Peripheral Lymphocyte-to-Monocyte Ratio as a Predictive Factor for Early Neurological Deterioration in Patients with Acute Ischemic Stroke

Liying Sun, Xuhui Ye, Junping Yu, Linlin Wang, Yan Wu, Jing Cui, Lihua Dai Intensive Care Unit, Shidong Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Lihua Dai, Intensive Care Unit, Shidong Hospital, Yangpu District, Shanghai, 200438, People’s Republic of China, Tel +86 18917059757, Email [email protected]: Previous studies have reported that lymphocyte-to-monocyte ratio (LMR) is associated with the prognosis of patients with acute ischemic stroke (AIS); however, the relationship between LMR and early neurological deterioration (END) in AIS patients has not been elucidated.Patients and Methods: Patients were divided into two groups according to LMR by using receiver operating characteristic (ROC) curve analysis. Patients with END were confirmed as the National Institutes of Health Stroke Scale (NIHSS) increased ≥ 4 points between hospital days 0 and 5. Multivariate logistic regression analysis was used to analyze the factors independently related to END in patients with AIS.Results: In total, 202 patients diagnosed with AIS were enrolled in this retrospective study. Using ROC curve analysis, patients were divided into two groups according to LMR: low LMR group (LMR < 3.24, n = 95) and high LMR group (LMR ≥ 3.24, n = 107). The frequencies of END were significantly higher in the low LMR group compared to the high LMR group (41.05 vs.15.89%, p < 0.001). Multivariate logistic regression showed that age (OR = 1.03, 95% CI 1.01– 1.06, p = 0.04), infarct volume (OR = 1.01, 95% CI 1.00– 1.02, p = 0.001), neutrophil count (OR = 1.17, 95% CI 1.03– 1.33, p = 0.018), and LMR (OR = 2.49, 95% CI 1.01– 9.11, p = 0.018) were independently associated with END in AIS patients.Conclusion: A peripheral LMR levels at admission were significantly associated with END and LMR < 3.24 is an independent predictive factor of END in patients with AIS.Keywords: lymphocyte-to-monocyte ratio, acute ischemic stroke, early neurological deterioration, national institutes of health stroke scale