Year 2022,
Volume: 12 Issue: 2, 93 - 97, 31.08.2022
İrem Yıldırım
Halit Güneş
Kürşat Usalan
References
- 1. Xue J, Huang W, Chen X, Li Q, Cai Z, Yu T et al. Neutrophilto-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2017;26(3):650–657. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.010 Epub 2016 Dec 9. PMID: 27955949.
- 2. Balta S, Demırkol S, Kucuk U. The platelet lymphocyte ratio may be useful inflammatory indicator in clinical practice. Hemodial Int. 2013;17(4):668–9. doi: 10.1111/hdi.12058 Epub 2013 Jun 14. PMID: 23763539.
- 3. Icme F, San I, Yuzbasioglu Y. The prognostic relationship between complete blood count parameters and infarct positive transient ischemic attack, infarct negative transient ischemic attack and ischemic stroke, Acta Med Mediterr. 2016;32:97.
- 4. Tokgoz S, Kayrak M, Akpinar Z, Seyithanoğlu A, Güney F, Yuruten B. Neutrophil lymphocyte ratio as a predictor of stroke. J Stroke Cerebrovasc Dis. 2013;22(7):1169–74. doi: 10.1016/j. jstrokecerebrovasdis.2013.01.011 Epub 2013 Mar 14. PMID: 23498372.
- 5. Altintas O, Altintas MO, Tasal A, Kucukdagli OT, Asil T. The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res. 2016;38(9):759–65. doi: 10.1080/01616412.2016.1215030 Epub 2016 Jul 30. PMID: 27477691.
- 6. Yu S, Arima H, Bertmar C, Clarke S, Herkes G, Krause M. Neutrophil to lymphocyte ratio and early clinical outcomes in patients with acute ischemic stroke. J Neurol Sci. 2018;387:115–118. doi: 10.1016/j. jns.2018.02.002 Epub 2018 Feb 2. PMID: 29571846.
- 7. Jiang H, Zhang J, Wu J, Wei G, He Y, Gao X. Neutrophil-toLymphocyte Ratio Correlates with Severity of Extracranial Carotid Stenosis-A Study Using Digital Subtraction Angiography. J Stroke Cerebrovasc Dis. 2017;26(6):1182– 1190. doi:10.1016/j.jstrokecerebrovasdis.2017.01.002 Epub 2017 Mar 6. PMID: 28279551.
- 8. Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, et al. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-tolymphocyte ratio. J Clin Lab Anal. 2019;33(3):e22714. doi: 10.1002/jcla.22714 Epub 2018 Nov 9. PMID: 30411816; PMCID: PMC6818602.
- 9. Fan L, Gui L, Chai EQ, Wei CJ. Routine hematological parameters are associated with short- and long-term prognosis of patients with ischemic stroke. J Clin Lab Anal. 2018;32(2):e22244. doi: 10.1002/jcla.22244 Epub 2017 May 22. PMID: 28543551; PMCID: PMC6816821.
- 10. Suh B, Shin DW, Kwon HM, Yun JM, Yang HK, Ahn E, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One. 2017;12(8): e0183706. doi: 10.1371/journal.pone.0183706 PMID: 28829826; PMCID: PMC5567907.
- 11. Chen C, Gu L, Chen L, Hu W, Feng X, Qiu F, Fan Z, Chen Q, Qiu J, Shao B. Neutrophil-to-Lymphocyte Ratio and Platelet-toLymphocyte Ratio as Potential Predictors of Prognosis in Acute Ischemic Stroke. Front Neurol. 2021;11:525621. doi: 10.3389/fneur.2020.525621 PMID: 33569032; PMCID: PMC7868420.
- 12. Yan YK, Huang H, Li DP, Ai ZY, Li X, Sun Z. Prognostic value of the platelet-to-lymphocyte ratio for outcomes of stroke: a systematic review and meta-analysis. European Review for Medical and Pharmacological Sciences. 2021;25(21):6529–38
Evaluation of Neutrophil/Lymphocyte and Platelet/ Lymphocyte Ratio Values in Patients with Ischemic Stroke in Terms of Disease Severity Based on NIHSS
Year 2022,
Volume: 12 Issue: 2, 93 - 97, 31.08.2022
İrem Yıldırım
Halit Güneş
Kürşat Usalan
Abstract
Aim: Stroke is the most common neurological cause of morbidity and mortality worldwide. Therefore, controlling the risk factors in an early phase is critically important. In this study, we aimed to
investigate the advantages of neutrophile lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) values against each other in predicting the prognosis of ischemic stroke.
Material and Method: 143 ischemic stroke patients were included in to study. Blood sample analysis was done to calculate NLR and PLR. Patients’ NIHSS at first admission was also calculated.
Multiple statistical analyses were used to analyze the statistical significance of NLR and PLR’s predictive power in poor prognosis.
Results: We found that NLR was lower in those with a stroke scale score of 5 and below; the difference was statistically significant (p=0.015). The results of the ROC curve analysis showed that the
NLR value was statistically significant in predicting patients categorized as NIHSS 6 and above (p<0.001).
Conclusion: This study is one of the first in the literature to evaluate the advantages of NLR and PLR values against one another in predicting stroke prognosis. Results show that the
NLR value has a higher statistical significance in predicting prognosis than the PLR value. It is believed that prospective randomized studies can draw more meaningful conclusions on a larger set of patients.
References
- 1. Xue J, Huang W, Chen X, Li Q, Cai Z, Yu T et al. Neutrophilto-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2017;26(3):650–657. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.010 Epub 2016 Dec 9. PMID: 27955949.
- 2. Balta S, Demırkol S, Kucuk U. The platelet lymphocyte ratio may be useful inflammatory indicator in clinical practice. Hemodial Int. 2013;17(4):668–9. doi: 10.1111/hdi.12058 Epub 2013 Jun 14. PMID: 23763539.
- 3. Icme F, San I, Yuzbasioglu Y. The prognostic relationship between complete blood count parameters and infarct positive transient ischemic attack, infarct negative transient ischemic attack and ischemic stroke, Acta Med Mediterr. 2016;32:97.
- 4. Tokgoz S, Kayrak M, Akpinar Z, Seyithanoğlu A, Güney F, Yuruten B. Neutrophil lymphocyte ratio as a predictor of stroke. J Stroke Cerebrovasc Dis. 2013;22(7):1169–74. doi: 10.1016/j. jstrokecerebrovasdis.2013.01.011 Epub 2013 Mar 14. PMID: 23498372.
- 5. Altintas O, Altintas MO, Tasal A, Kucukdagli OT, Asil T. The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res. 2016;38(9):759–65. doi: 10.1080/01616412.2016.1215030 Epub 2016 Jul 30. PMID: 27477691.
- 6. Yu S, Arima H, Bertmar C, Clarke S, Herkes G, Krause M. Neutrophil to lymphocyte ratio and early clinical outcomes in patients with acute ischemic stroke. J Neurol Sci. 2018;387:115–118. doi: 10.1016/j. jns.2018.02.002 Epub 2018 Feb 2. PMID: 29571846.
- 7. Jiang H, Zhang J, Wu J, Wei G, He Y, Gao X. Neutrophil-toLymphocyte Ratio Correlates with Severity of Extracranial Carotid Stenosis-A Study Using Digital Subtraction Angiography. J Stroke Cerebrovasc Dis. 2017;26(6):1182– 1190. doi:10.1016/j.jstrokecerebrovasdis.2017.01.002 Epub 2017 Mar 6. PMID: 28279551.
- 8. Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, et al. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-tolymphocyte ratio. J Clin Lab Anal. 2019;33(3):e22714. doi: 10.1002/jcla.22714 Epub 2018 Nov 9. PMID: 30411816; PMCID: PMC6818602.
- 9. Fan L, Gui L, Chai EQ, Wei CJ. Routine hematological parameters are associated with short- and long-term prognosis of patients with ischemic stroke. J Clin Lab Anal. 2018;32(2):e22244. doi: 10.1002/jcla.22244 Epub 2017 May 22. PMID: 28543551; PMCID: PMC6816821.
- 10. Suh B, Shin DW, Kwon HM, Yun JM, Yang HK, Ahn E, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One. 2017;12(8): e0183706. doi: 10.1371/journal.pone.0183706 PMID: 28829826; PMCID: PMC5567907.
- 11. Chen C, Gu L, Chen L, Hu W, Feng X, Qiu F, Fan Z, Chen Q, Qiu J, Shao B. Neutrophil-to-Lymphocyte Ratio and Platelet-toLymphocyte Ratio as Potential Predictors of Prognosis in Acute Ischemic Stroke. Front Neurol. 2021;11:525621. doi: 10.3389/fneur.2020.525621 PMID: 33569032; PMCID: PMC7868420.
- 12. Yan YK, Huang H, Li DP, Ai ZY, Li X, Sun Z. Prognostic value of the platelet-to-lymphocyte ratio for outcomes of stroke: a systematic review and meta-analysis. European Review for Medical and Pharmacological Sciences. 2021;25(21):6529–38