Higher Neutrophil-Percentage-to-Albumin Ratio Was Associated with Poor Outcome in Endovascular Thrombectomy Patients

Maoxia Xu,* Qian Zhai,* Bin Wei,* Shuaiyu Chen, Yan E, Zhihang Huang, Jinwen Qi, Yiming Xu Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yiming Xu, Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 86 Changle Road, Nanjing, Jiangsu Province, 210000, People’s Republic of China, Tel/Fax +86 02552271000, Email [email protected] and Purpose: The neutrophil percentage-to-albumin ratio (NPAR) is connected with all-cause mortality and stroke-related pneumonia. The purpose of this study was to assess the diagnostic efficacy of NPAR in predicting functional outcomes at 90 days after endovascular thrombectomy (EVT).Methods: We retrospective analyzed consecutive patients who underwent EVT at Nanjing First Hospital from October 2019 to June 2024. NPAR was defined as the percentage of neutrophils divided by the albumin levels. An unfavorable outcome was indicated by a modified Rankin Scale score of 3– 6 at 90 days. Multivariable logistic regression models were utilized to investigate the association between NPAR and functional outcomes after EVT treatment.Results: A total of 713 patients (mean age, 70.5 ± 11.9 years; 430 males) were finally enrolled for analysis. Among these, 357 (50.1%) patients exhibited unfavorable outcomes at 90 days. Multivariate regression analysis indicated that elevated NPAR levels at admission were independently associated with poor outcome (adjusted odds ratio: 6.921; 95% confidence interval, 4.216– 11.363; P= 0.001) in ischemic stroke patients undergoing EVT. Furthermore, the restricted cubic spline observed a positive and nonlinear association between the NPAR and poor outcome at 90 days (P for linearity=0.001).Conclusion: This study indicated that higher NPAR levels were associated an increased risk of poor outcome at 90 days in patients treated with EVT, suggesting that NPAR could serve as a viable prognostic biomarker for ischemic stroke after EVT.Keywords: ischemic stroke, NPAR, albumin, thrombectomy