Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients
Abstract Background and purpose Intravenous thrombolysis (IVT) has become the standard treatment for acute ischemic stroke within 4.5 hr after symptoms onset. However, a fraction of patients would develop early neurological deterioration (END) after IVT. The aim of our study was to explore the utili...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-10-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.1426 |
| _version_ | 1818509604877762560 |
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| author | Pengyu Gong Yi Xie Teng Jiang Yukai Liu Meng Wang Huanhuan Sun Shuting Zhang Yingdong Zhang Xiaohao Zhang Junshan Zhou |
| author_facet | Pengyu Gong Yi Xie Teng Jiang Yukai Liu Meng Wang Huanhuan Sun Shuting Zhang Yingdong Zhang Xiaohao Zhang Junshan Zhou |
| author_sort | Pengyu Gong |
| collection | DOAJ |
| description | Abstract Background and purpose Intravenous thrombolysis (IVT) has become the standard treatment for acute ischemic stroke within 4.5 hr after symptoms onset. However, a fraction of patients would develop early neurological deterioration (END) after IVT. The aim of our study was to explore the utility of neutrophil–lymphocyte ratio (NLR) in predicting END. Methods From October 2016 to March 2018, 342 consecutive patients with thrombolytic therapy were prospectively enrolled in this study. Blood cell counts were sampled in stroke emergency room before IVT. END was defined as a National Institutes of Health Stroke Scale score increase of ≥4 points within 24 hr after IVT. Multiple regression analysis was used to investigate the potential risk factors of END. We also performed receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the NLR in predicting END. Results Of the 342 patients, 86 (25.1%) participants were identified with END. Univariate logistic regression analysis demonstrated that patients with NLR in the third tertile, compared with the first tertile, were more likely to have END (odds ratio, 9.783; 95% confidence interval [CI], 4.847–19.764; p = .001). The association remained significant even after controlled for potential confounders. Also, a cutoff value of 4.43 for NLR was detected in predicting post‐thrombolysis END with a sensitivity of 70.9% and a specificity of 79.3% (area under curve, 0.779; 95% CI, 0.731–0.822). Furthermore, our established nomogram indicated that higher NLR was an indicator of post‐thrombolysis END (c‐index was 0.789, p < .001). Conclusions This study showed that elevated level of NLR may predict post‐thrombolysis END in ischemic stroke patients. |
| first_indexed | 2024-12-10T22:47:42Z |
| format | Article |
| id | doaj.art-2d237928ed2b4ba8a70e3c26567857a0 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-12-10T22:47:42Z |
| publishDate | 2019-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-2d237928ed2b4ba8a70e3c26567857a02022-12-22T01:30:32ZengWileyBrain and Behavior2162-32792019-10-01910n/an/a10.1002/brb3.1426Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patientsPengyu Gong0Yi Xie1Teng Jiang2Yukai Liu3Meng Wang4Huanhuan Sun5Shuting Zhang6Yingdong Zhang7Xiaohao Zhang8Junshan Zhou9Department of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Jinling Hospital Medical School of Nanjing University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaDepartment of Neurology Second Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing ChinaDepartment of Neurology Nanjing First Hospital Nanjing Medical University Nanjing ChinaAbstract Background and purpose Intravenous thrombolysis (IVT) has become the standard treatment for acute ischemic stroke within 4.5 hr after symptoms onset. However, a fraction of patients would develop early neurological deterioration (END) after IVT. The aim of our study was to explore the utility of neutrophil–lymphocyte ratio (NLR) in predicting END. Methods From October 2016 to March 2018, 342 consecutive patients with thrombolytic therapy were prospectively enrolled in this study. Blood cell counts were sampled in stroke emergency room before IVT. END was defined as a National Institutes of Health Stroke Scale score increase of ≥4 points within 24 hr after IVT. Multiple regression analysis was used to investigate the potential risk factors of END. We also performed receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the NLR in predicting END. Results Of the 342 patients, 86 (25.1%) participants were identified with END. Univariate logistic regression analysis demonstrated that patients with NLR in the third tertile, compared with the first tertile, were more likely to have END (odds ratio, 9.783; 95% confidence interval [CI], 4.847–19.764; p = .001). The association remained significant even after controlled for potential confounders. Also, a cutoff value of 4.43 for NLR was detected in predicting post‐thrombolysis END with a sensitivity of 70.9% and a specificity of 79.3% (area under curve, 0.779; 95% CI, 0.731–0.822). Furthermore, our established nomogram indicated that higher NLR was an indicator of post‐thrombolysis END (c‐index was 0.789, p < .001). Conclusions This study showed that elevated level of NLR may predict post‐thrombolysis END in ischemic stroke patients.https://doi.org/10.1002/brb3.1426acute ischemic strokeearly neurological deteriorationintravenous thrombolysisneutrophil–lymphocyte ratiorisk factor |
| spellingShingle | Pengyu Gong Yi Xie Teng Jiang Yukai Liu Meng Wang Huanhuan Sun Shuting Zhang Yingdong Zhang Xiaohao Zhang Junshan Zhou Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients Brain and Behavior acute ischemic stroke early neurological deterioration intravenous thrombolysis neutrophil–lymphocyte ratio risk factor |
| title | Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients |
| title_full | Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients |
| title_fullStr | Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients |
| title_full_unstemmed | Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients |
| title_short | Neutrophil–lymphocyte ratio predicts post‐thrombolysis early neurological deterioration in acute ischemic stroke patients |
| title_sort | neutrophil lymphocyte ratio predicts post thrombolysis early neurological deterioration in acute ischemic stroke patients |
| topic | acute ischemic stroke early neurological deterioration intravenous thrombolysis neutrophil–lymphocyte ratio risk factor |
| url | https://doi.org/10.1002/brb3.1426 |
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