Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy
PurposeOnly approximately half of anterior circulation large vessel occlusion (LVO) patients receiving endovascular treatment (EVT) have a favorable outcome. The aim of this study was to explore the association of dynamic inflammatory markers (i.e., neutrophil to lymphocyte ratios, NLR, measured at...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.963111/full |
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| author | Yao Feng Yao Feng Xuesong Bai Xuesong Bai Wei Li Wei Li Wenbo Cao Wenbo Cao Xin Xu Xin Xu Fan Yu Fan Yu Zhaolin Fu Zhaolin Fu Qiuyue Tian Xiaofan Guo Tao Wang Tao Wang Arman Sha Arman Sha Yanfei Chen Yanfei Chen Peng Gao Peng Gao Peng Gao Yabing Wang Yabing Wang Jian Chen Yan Ma Yan Ma Fei Chen Adam A. Dmytriw Robert W. Regenhardt Jie Lu Jie Lu Qingfeng Ma Bin Yang Bin Yang Liqun Jiao Liqun Jiao Liqun Jiao |
| author_facet | Yao Feng Yao Feng Xuesong Bai Xuesong Bai Wei Li Wei Li Wenbo Cao Wenbo Cao Xin Xu Xin Xu Fan Yu Fan Yu Zhaolin Fu Zhaolin Fu Qiuyue Tian Xiaofan Guo Tao Wang Tao Wang Arman Sha Arman Sha Yanfei Chen Yanfei Chen Peng Gao Peng Gao Peng Gao Yabing Wang Yabing Wang Jian Chen Yan Ma Yan Ma Fei Chen Adam A. Dmytriw Robert W. Regenhardt Jie Lu Jie Lu Qingfeng Ma Bin Yang Bin Yang Liqun Jiao Liqun Jiao Liqun Jiao |
| author_sort | Yao Feng |
| collection | DOAJ |
| description | PurposeOnly approximately half of anterior circulation large vessel occlusion (LVO) patients receiving endovascular treatment (EVT) have a favorable outcome. The aim of this study was to explore the association of dynamic inflammatory markers (i.e., neutrophil to lymphocyte ratios, NLR, measured at different times after EVT) as well as other potential influencing factors with unfavorable outcome among acute ischemic stroke (AIS) patients who achieved complete reperfusion after EVT.MethodsPatients treated with EVT for LVO between January 2019 to December 2021 were prospectively enrolled. Complete reperfusion was defined as modified thrombolysis in cerebral infarction (mTICI) grade 3. A modified Rankin scale at 90 days (mRS90) of 3–6 was defined as unfavorable outcome (i.e., futile reperfusion). A logistic regression analysis was performed with unfavorable outcome as a dependent variable. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were then used to determine the diagnostic values of NLR and other relevant factors.Results170 patients with complete reperfusion (mTICI 3) were included in this study. Unfavorable outcome was observed in 70 (41.2%). Higher NLR within 24h (p=0.017) and at 3-7d (p=0.008) after EVT were an independent risk factors for unfavorable outcome at 3 months. In addition, older age, higher NIHSS scores, poor collaterals, and general anesthesia were independent predictors of unfavorable outcomes. When accounting for NLR, the diagnostic efficiency improved compared to conventional characteristics.ConclusionOur findings suggest that advanced age, increased stroke severity, poor collaterals, general anesthesia, and NLR are independent predictors for an unfavorable clinical outcome following complete reperfusion after EVT. Neuroinflammation may merit particular attention in future studies. |
| first_indexed | 2024-04-12T13:50:55Z |
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| id | doaj.art-202b98d275304ed7b8ad3ca9503c06e3 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-12T13:50:55Z |
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| series | Frontiers in Immunology |
| spelling | doaj.art-202b98d275304ed7b8ad3ca9503c06e32022-12-22T03:30:31ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.963111963111Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomyYao Feng0Yao Feng1Xuesong Bai2Xuesong Bai3Wei Li4Wei Li5Wenbo Cao6Wenbo Cao7Xin Xu8Xin Xu9Fan Yu10Fan Yu11Zhaolin Fu12Zhaolin Fu13Qiuyue Tian14Xiaofan Guo15Tao Wang16Tao Wang17Arman Sha18Arman Sha19Yanfei Chen20Yanfei Chen21Peng Gao22Peng Gao23Peng Gao24Yabing Wang25Yabing Wang26Jian Chen27Yan Ma28Yan Ma29Fei Chen30Adam A. Dmytriw31Robert W. Regenhardt32Jie Lu33Jie Lu34Qingfeng Ma35Bin Yang36Bin Yang37Liqun Jiao38Liqun Jiao39Liqun Jiao40Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Liaocheng Brain Hospital, Liaocheng, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Neurology, Loma Linda University Health, Loma Linda, CA, United StatesDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China0Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States0Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaPurposeOnly approximately half of anterior circulation large vessel occlusion (LVO) patients receiving endovascular treatment (EVT) have a favorable outcome. The aim of this study was to explore the association of dynamic inflammatory markers (i.e., neutrophil to lymphocyte ratios, NLR, measured at different times after EVT) as well as other potential influencing factors with unfavorable outcome among acute ischemic stroke (AIS) patients who achieved complete reperfusion after EVT.MethodsPatients treated with EVT for LVO between January 2019 to December 2021 were prospectively enrolled. Complete reperfusion was defined as modified thrombolysis in cerebral infarction (mTICI) grade 3. A modified Rankin scale at 90 days (mRS90) of 3–6 was defined as unfavorable outcome (i.e., futile reperfusion). A logistic regression analysis was performed with unfavorable outcome as a dependent variable. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were then used to determine the diagnostic values of NLR and other relevant factors.Results170 patients with complete reperfusion (mTICI 3) were included in this study. Unfavorable outcome was observed in 70 (41.2%). Higher NLR within 24h (p=0.017) and at 3-7d (p=0.008) after EVT were an independent risk factors for unfavorable outcome at 3 months. In addition, older age, higher NIHSS scores, poor collaterals, and general anesthesia were independent predictors of unfavorable outcomes. When accounting for NLR, the diagnostic efficiency improved compared to conventional characteristics.ConclusionOur findings suggest that advanced age, increased stroke severity, poor collaterals, general anesthesia, and NLR are independent predictors for an unfavorable clinical outcome following complete reperfusion after EVT. Neuroinflammation may merit particular attention in future studies.https://www.frontiersin.org/articles/10.3389/fimmu.2022.963111/fullacute ischemic strokeendovascular treatmentNLRinflammationprognosisreperfusion |
| spellingShingle | Yao Feng Yao Feng Xuesong Bai Xuesong Bai Wei Li Wei Li Wenbo Cao Wenbo Cao Xin Xu Xin Xu Fan Yu Fan Yu Zhaolin Fu Zhaolin Fu Qiuyue Tian Xiaofan Guo Tao Wang Tao Wang Arman Sha Arman Sha Yanfei Chen Yanfei Chen Peng Gao Peng Gao Peng Gao Yabing Wang Yabing Wang Jian Chen Yan Ma Yan Ma Fei Chen Adam A. Dmytriw Robert W. Regenhardt Jie Lu Jie Lu Qingfeng Ma Bin Yang Bin Yang Liqun Jiao Liqun Jiao Liqun Jiao Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy Frontiers in Immunology acute ischemic stroke endovascular treatment NLR inflammation prognosis reperfusion |
| title | Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| title_full | Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| title_fullStr | Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| title_full_unstemmed | Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| title_short | Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| title_sort | postoperative neutrophil lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy |
| topic | acute ischemic stroke endovascular treatment NLR inflammation prognosis reperfusion |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.963111/full |
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