Objective:To investigate the predictive value of inflammatory indicators on the occurrence of depression and suicidal ideation after ischemic stroke in the elderly.Methods:A total of 263 elderly patients admitted to the hospital with first diagnosis of acute ischemic stroke from January 2018 to January 2021 were selected as the ischemic stroke group,and 200 healthy elderly patients who underwent physical examination during the same period were selected as the elderly normal control group.The differences in their peripheral blood neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were compared.Patients in the ischemic stroke group were divided into a post-stroke depression(PSD)group,and a non-PSD group according to their depres-sion at 6 months after discharge.Factors influencing the occurrence of PSD were analyzed using univariate analysis and multi-fac-tor logistic regression.Subject work characteristic(ROC)line was used to analyze the predictive value of early admission NLR and PLR levels in elderly patients with ischemic stroke on the emergence of suicidal ideation during the follow-up period.Results:The levels of peripheral blood NLR and PLR in the early stage of admission were higher in the ischemic stroke group than in the elderly normal control group,with statistically significant differences(t=18.962,12.442,P＜0.05).Advanced age,higher NIHSS score at the time of admission,education,widowhood and higher levels of NLR,PLR,and hypersensitive C-reactive protein(hs-CRP)were independent risk factors for the development of PSD in the elderly(t/χ2=9.639,5.826,10.162,15.148,4.449,3.471,5.215,P＜0.05).The best cut-off value for NLR to predict the emergence of suicidal ideation in elderly patients with ischemic stroke within 6 months after hospital discharge was 3.81,with an AUC of 0.751[95%CI(0.657,0.845)],corresponding to a sensitivity and specificity of 68.53%and 64.52%,respectively.The best cut-off value for PLR to predict the emergence of suicidal ideation in elderly patients with ischemic stroke within 6 months after hospital discharge was 144.20,with an AUC of 0.800[95%CI(0.708,0.892)],corresponding to a sensitivity and specificity of 73.28%and 74.19%,respectively.Conclusion:Higher peripheral blood NLR and PLR levels in early admission are independent risk factors for the development of depression after ischemic stroke in the elderly and have a predictive value for the subsequent emergence of suicidal ideation.
Ischemic stroke in the elderlyDepressionNeutrophil-to-lymphocyte ratioPlatelet-to-lymphocyte ratioSuicidal ideationPrediction
NETL
NSTL
万方数据
