A Study on the Neutrophil Lymphocyte Ratio as a Predictor of Mortality inPatients with Acute Cerebrovascular Accident at Tertiary Care Center

Background: Stroke is a growing public health problem which remains as a leading cause of mortalityworldwide. Among different stroke subtypes, ischemic stroke (IS) is the most common type, constituting foraround 80% of all strokes. The neutrophil-to-lymphocyte ratio (NLR) is an easily accessible marker of systemicinflammatory status, implying the balance between neutrophil and lymphocytes in the peripheral blood. Rise inNLR levels were reported to be linked with atherosclerotic events, acting as a prognostic predictor in coronaryartery disease (CAD), peripheral arterial occlusive disease (PAD), and stroke. High NLR levels were associatedwith the severity of stroke, poor functional outcomes, and recurrent ischemic attacks.Aim: To study neutrophil-lymphocyte ratio as a predictor of mortality in patients with acute cerebrovascularaccident (CVA) at tertiary care center.Patients and Methods: This was a Prospective Observational study conducted in 100 patients in theDepartment of General Medicine, GMC, GGH, Kadapa, India selected by Simple Random sampling.Results & Conclusion: The present study showed a positive relation between raised NLR and mortality risk instroke patients. Sensitivity, PPV, NPV and diagnostic accuracy of NLR in detecting mortality was 78.5%,100%, 96.63% and 91.48% at a cut off value of 9.3. Early management is important, to reduce mortality andimprove outcomes. NLR may help to select risky patients to start intervention on time. We conclude that higherNLR can predict post stroke mortality risk also.