Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke
Background: We aimed to determine whether higher neutrophil counts (NC) and neutrophil-to-lymphocyte ratio (NLR) were independently predictive of worse in-hospital outcome in patients after acute ischemic stroke (IS). Methods: A retrospective observational study with prospective manner of IS registr...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-06-01
|
| Series: | Biomedical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417016301263 |
| _version_ | 1817997689326927872 |
|---|---|
| author | Yen-Nan Fang Meng-Shen Tong Pei-Hsun Sung Yung-Lung Chen Chih-Hung Chen Nei-Wen Tsai Chih-Jen Huang Ya-Ting Chang Shu-Fang Chen Wen-Neng Chang Cheng-Hsien Lu Hon-Kan Yip |
| author_facet | Yen-Nan Fang Meng-Shen Tong Pei-Hsun Sung Yung-Lung Chen Chih-Hung Chen Nei-Wen Tsai Chih-Jen Huang Ya-Ting Chang Shu-Fang Chen Wen-Neng Chang Cheng-Hsien Lu Hon-Kan Yip |
| author_sort | Yen-Nan Fang |
| collection | DOAJ |
| description | Background: We aimed to determine whether higher neutrophil counts (NC) and neutrophil-to-lymphocyte ratio (NLR) were independently predictive of worse in-hospital outcome in patients after acute ischemic stroke (IS).
Methods: A retrospective observational study with prospective manner of IS registration. Between April 2012 and August 2014, a total number of 1731 patients with post-IS were consecutively enrolled in the study. Blood samples were drawn upon admission. Primary endpoint was in-hospital mortality. Secondary endpoint was severe stroke (≥16 NIHSS).
Results: The NC progressively increased from mild (NIHSS ≤ 5) to moderate (NIHSS ≥ 6 < 16) and severe (NIHSS ≥ 16) stroke (p = 0.006). NLR was independently associated with in-hospital mortality (p = 0.002). Multiple stepwise linear regression analysis showed that NC (p = 0.001) and NLR (p = 0.002) were independently predictive of higher NIHSS. Multiple stepwise logistic regression analysis showed that NC was independently associated with severe stroke (p < 0.0001). The best discriminating factor for in-hospital mortality with respect to NLR was ≥3.20 (sensitivity 62.7%, specificity 60.3%, likelihood ratio: 12.2). Patients with NLR ≥3.20 had a 2.55-fold increased risk for in-hospital mortality (OR = 1.49–4.37) compared to patients with NLR <3.20. The best discriminating factor for severe stroke (≥16 NIHSS) with respect to NC was ≥74% (sensitivity 47.1%, specificity 74.0%, likelihood ratio: 29.0). Patients with NC >74% had a 2.54-fold increased risk of severe stroke (OR = 1.82–3.54) compared to patients with NC <74%.
Conclusion: NLR was independently associated with in-hospital mortality and higher NC was independently predictive of severe stroke. |
| first_indexed | 2024-04-14T02:40:57Z |
| format | Article |
| id | doaj.art-212fd270a33c4c5183d5549ed9a1b280 |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-04-14T02:40:57Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-212fd270a33c4c5183d5549ed9a1b2802022-12-22T02:16:56ZengElsevierBiomedical Journal2319-41702017-06-0140315416210.1016/j.bj.2017.03.002Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic strokeYen-Nan Fang0Meng-Shen Tong1Pei-Hsun Sung2Yung-Lung Chen3Chih-Hung Chen4Nei-Wen Tsai5Chih-Jen Huang6Ya-Ting Chang7Shu-Fang Chen8Wen-Neng Chang9Cheng-Hsien Lu10Hon-Kan Yip11Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of General Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanBackground: We aimed to determine whether higher neutrophil counts (NC) and neutrophil-to-lymphocyte ratio (NLR) were independently predictive of worse in-hospital outcome in patients after acute ischemic stroke (IS). Methods: A retrospective observational study with prospective manner of IS registration. Between April 2012 and August 2014, a total number of 1731 patients with post-IS were consecutively enrolled in the study. Blood samples were drawn upon admission. Primary endpoint was in-hospital mortality. Secondary endpoint was severe stroke (≥16 NIHSS). Results: The NC progressively increased from mild (NIHSS ≤ 5) to moderate (NIHSS ≥ 6 < 16) and severe (NIHSS ≥ 16) stroke (p = 0.006). NLR was independently associated with in-hospital mortality (p = 0.002). Multiple stepwise linear regression analysis showed that NC (p = 0.001) and NLR (p = 0.002) were independently predictive of higher NIHSS. Multiple stepwise logistic regression analysis showed that NC was independently associated with severe stroke (p < 0.0001). The best discriminating factor for in-hospital mortality with respect to NLR was ≥3.20 (sensitivity 62.7%, specificity 60.3%, likelihood ratio: 12.2). Patients with NLR ≥3.20 had a 2.55-fold increased risk for in-hospital mortality (OR = 1.49–4.37) compared to patients with NLR <3.20. The best discriminating factor for severe stroke (≥16 NIHSS) with respect to NC was ≥74% (sensitivity 47.1%, specificity 74.0%, likelihood ratio: 29.0). Patients with NC >74% had a 2.54-fold increased risk of severe stroke (OR = 1.82–3.54) compared to patients with NC <74%. Conclusion: NLR was independently associated with in-hospital mortality and higher NC was independently predictive of severe stroke.http://www.sciencedirect.com/science/article/pii/S2319417016301263Acute ischemic strokeIn-hospital mortalityDiscriminating factorSevere strokeTissue plasminogen activator |
| spellingShingle | Yen-Nan Fang Meng-Shen Tong Pei-Hsun Sung Yung-Lung Chen Chih-Hung Chen Nei-Wen Tsai Chih-Jen Huang Ya-Ting Chang Shu-Fang Chen Wen-Neng Chang Cheng-Hsien Lu Hon-Kan Yip Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke Biomedical Journal Acute ischemic stroke In-hospital mortality Discriminating factor Severe stroke Tissue plasminogen activator |
| title | Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke |
| title_full | Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke |
| title_fullStr | Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke |
| title_full_unstemmed | Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke |
| title_short | Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke |
| title_sort | higher neutrophil counts and neutrophil to lymphocyte ratio predict prognostic outcomes in patients after non atrial fibrillation caused ischemic stroke |
| topic | Acute ischemic stroke In-hospital mortality Discriminating factor Severe stroke Tissue plasminogen activator |
| url | http://www.sciencedirect.com/science/article/pii/S2319417016301263 |
| work_keys_str_mv | AT yennanfang higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT mengshentong higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT peihsunsung higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT yunglungchen higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT chihhungchen higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT neiwentsai higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT chihjenhuang higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT yatingchang higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT shufangchen higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT wennengchang higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT chenghsienlu higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke AT honkanyip higherneutrophilcountsandneutrophiltolymphocyteratiopredictprognosticoutcomesinpatientsafternonatrialfibrillationcausedischemicstroke |