Background: The neutrophil to lymphocyte ratio (NLR), representing change in inflammatory cell subpopulation, is closely linked to mortality in patients with cardiovascular disease. The prognostic role of NLR in patients with ischemic stroke remains unclear.
Objective: We investigated whether NLR was associated with early clinical outcome in patients with acute ischemic stroke.
Patients and methods: We collected data of patients with the first-ever acute ischemic stroke within 72 h of onset who were admitted to Royal North Shore Hospital from January 2009 to March 2013. White blood cell counts and peripheral differential counts were measured on admission. Early clinical outcomes were disability at discharge and in-hospital mortality assessed by the modified Rankin scale (mRS). We have obtained local Institutional Review Board approval.
Results: Among 1131 patients, 454 patients were included and classified into tertile groups based on NLR on admission. Patients in higher tertiles of NLR were likely to have severe neurologic deficit. Higher NLR tertiles were associated with a significant worse shift in the distribution of mRS scores in the ordinal logistic regression analysis (p < 0.0001 for trend). This association remained significant after adjustment for clinical and laboratory variables including age, sex, hypertension, smoking, stroke severity, and glucose level (p = 0.009 for trend). However, risk of death or major disability (score of 3–6 on mRS) and in-hospital mortality were not different according to NLR tertiles.
Conclusion: In patients with acute ischemic stroke, NLR on admission could be used to predict the short-term functional outcome.
© 2015 Published by Elsevier Inc.