Evaluation of NLR and PLR for early prognosis in acute ischemic stroke patients after rt-PA thrombolysis
Objective To study the prognostic value of the neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in peripheral blood for assessing the 3-month prognosis of patients with acute ischemic stroke(AIS)following rt-PA intravenous thrombolysis treatment.Methods A total of 202 AIS patients,who experienced their first stroke between January 2021 and January 2022 at the First Affiliated Hospital of Dalian Medical University,were included in this study.Based on the modified Rankin scale(mRS)score after 3 months,the patients were divided into two groups:favorable prognosis(143 cases)and poor prognosis(59 cases).General demographic and hematological parameters were collected,including NLR,PLR,and MHR.The independent risk factors for poor prognosis at 3 months post-AIS were analyzed using a logistic regression model.Results Significant differences were observed between the favorable and poor prognosis groups in terms of NIHSS score upon admission,atrial fibrillation,white blood cell count,neutrophil count,lymphocyte count,NLR,PLR,D-dimer,fibrinogen(FIB),and brain natriuretic peptide levels(P＜0.05).Both univariate and multivariate logistic regression analyses indicated that NLR,FIB,and NIHSS score upon admission were independent risk factors for a poor prognosis at 3 months post-AIS(P＜0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for NLR in predicting poor AIS outcome was 0.795(95%CI 0.721-0.870,P＜0.001)with a sensitivity of 66.10%and specificity of 88.80%,and the optimal cutoff was 3.31.The AUC for FIB was 0.653(95%CI 0.569-0.735,P＜0.001)with a sensitivity of 59.30%and specificity of 68.50%,and the optimal cutoff was 3.145.The AUC for NIHSS score upon admission was 0.883(95%CI 0.828-0.938,P＜0.001),with a sensitivity of 90.20%and a specificity of 72.90%,and the optimal cutoff value was 5.5.The AUC for the combination of NLR and FIB was 0.827(95%CI 0.758-0.829,P＜0.001),with a sensitivity of 69.50%and a specificity of 90.20%.The combination of NLR and FIB demonstrated superior predictive value for poor AIS outcome at 3 months when compared to a single marker.Conclusion NLR,FIB,and NIHSS score upon admission are independent risk factors for poor prognosis at 3 months in AIS patients.The combination of NLR and FIB offers greater prognostic value for poor outcomes at 3 months post-AIS than any single indicator.
acute ischemic strokeneutrophil to lymphocyte ratioplatelet to lymphocyte ratio
NETL
NSTL
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