Neutrophil-to-Lymphocyte Ratio Better Than High-Sensitivity C-Reactive Protein in Predicting Stroke-Associated Pneumonia in Afebrile Patients

Wu, Tong; Zhang, H; Tian, Xiaolin; Cao, Yongtong; D, Wei; Wu, Xin

doi:10.2147/ndt.s340189

Cited by 9 publications

(7 citation statements)

References 41 publications

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“…Studies have shown that high NLR, with cutoff values ranging from 2.44 to 3.75, is significantly associated with stroke-associated pneumonia [8,9,17,18]. Similarly, as shown in this study, patients with high NLR (≥2.72) were more likely to have pneumonia during the hospitalization for stroke than those with low NLR (9.1% vs. 6.3%, p < 0.001).…”

Section: Discussionsupporting

confidence: 83%

High Neutrophil-to-Lymphocyte Ratio Predicts One-Year Risk of Pneumonia Post-Stroke Discharge

et al. 2023

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Introduction: The neutrophil-to-lymphocyte ratio (NLR) may predict stroke-associated pneumonia, which is generally defined as pneumonia occurring in the first week after stroke. However, little is known whether the initial NLR is associated with pneumonia risk during the long-term follow-up in stroke survivors. We aimed to determine the relationship between admission NLR and the risk of post-stroke pneumonia within 1 year after discharge from acute stroke care. Methods: Hospital databases were searched to identify adult patients hospitalized for acute stroke. Admission NLR was extracted using differential leukocyte counts. The outcome of interest was hospitalized pneumonia occurring within 1 year after discharge from hospitalization for stroke. Multivariable Cox proportional-hazards models were used to determine the independent effects of the NLR on the risk of pneumonia. Results: In this study, 5,741 patients with acute stroke (mean age, 68 years; men, 62.1%) were analyzed. The median NLR was 2.72 (interquartile range, 1.78–4.49). Of the patients, 342 (6.0%) developed pneumonia within 1 year after discharge. In the multivariable models, the NLR was a significant predictor of pneumonia after discharge whether it was analyzed as a continuous or dichotomized variable. The corresponding adjusted hazard ratios were 1.037 (95% confidence interval [CI], 1.013–1.061) and 1.361 (95% CI, 1.087–1.704), respectively. Conclusion: The NLR could predict the risk of post-stroke pneumonia up to 1 year after discharge from acute stroke care. It may help identify high-risk stroke survivors, for whom appropriate interventions can be targeted.

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Section: Discussionsupporting

confidence: 83%

High Neutrophil-to-Lymphocyte Ratio Predicts One-Year Risk of Pneumonia Post-Stroke Discharge

et al. 2023

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“…Endothelial cells are also damaged in patients with stroke, leading to platelet activation, the expression of adhesion molecules, and the release of inflammatory factors, resulting in atherosclerosis, thrombosis, and a decrease in platelet count (McMorran et al., 2009 ; Modjeski & Morrell, 2014 ). In addition, it has been shown that T‐lymphocytes and neutrophil‐to‐lymphocyte ratio have been shown to predict SAP development (Feng et al., 2018 ; Wu, Zhang et al., 2021 ). However, SII provides a more stable and objective response to changes in neutrophil, lymphocyte, and platelet counts in patients with stroke and can be used to predict SAP.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of the systemic immune inflammation (SII) index for stroke‐associated pneumonia

Cui,

Kuang,

Yang

et al. 2023

Brain and Behavior

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ObjectiveTo investigate the predictive value of the systemic immune inflammation (SII) index on the occurrence of stroke‐associated pneumonia (SAP) in patients with acute stroke.MethodsData of patients with or without a previous history of pulmonary who visited the First Affiliated Hospital of Kunming Medical University within 24 h of the onset of stroke were collected between January 2017 and December 2019. Patient's demographic data, stroke type, past medical history, National Institutes of Health Stroke Scale score, Glasgow Coma score, and laboratory tests were collected. Logistic regression models and receiver‐operating characteristic (ROC) curves were used to investigate the predictive value of SII for the development of SAP in patients with stroke.ResultsWe included 395 patients with acute stroke, with a mean age of 63.89 ± 13.42 years, of whom 340 (86.1%) had ischemic stroke, and 55 (13.9%) had hemorrhagic stroke. Out of 395, 113 (28.6%) had SAP and 282 (71.4%) did not, and the SII level in the SAP group was higher than that of the non‐SAP group (p < .05). Logistic regression analysis of patients with stroke showed that higher SII was a risk factor for SAP in patients with stroke (per 100 units, HR = 1.081, 95% CI: 1.035–1.130, p < .001), and tertile grouping of SII showed that the risk of SAP was 5.059 times higher in the SIIQ3 group than in the SIIQ1 group (95% CI: 2.061–12.418, p < .001). ROC curve analysis indicated that the SII index had predictive value for the occurrence of SAP in patients with stroke, with an area under the curve of 0.752 (95% CI: 0.698–0.806). When the cutoff value was 861.01, the SII predicted SAP in patients with stroke with a sensitivity of 61.9% and a specificity of 76.2%.ConclusionHigher SII is an independent risk factor for the development of SAP in patients with stroke and has some predictive value for the development of SAP.

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“…Compared to high-sensitivity C-reactive protein, NLR is strongly associated with the occurrence of stroke-associated pneumonia. 16 Hu et al 17 reported that NLR is associated with 90-day poor outcomes in stroke patients, however, the AUC of high NLR was insufficiently high to predict the poor outcome. In contrast, the AUC of NLR (0.717) in the present study had a good predictive value.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients with Chronic Internal Carotid Artery Occlusion Complicated by Cerebral Infarction

Zhuo-yin¹,

Guo²,

Sheng³

et al. 2022

NDT

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Purpose This study aims to investigate the prognostic value of the peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with chronic internal carotid artery occlusion (CICAO) complicated by cerebral infarction. Patients and Methods The clinical data of 99 CICAO patients complicated by cerebral infarction were retrospectively analyzed. The modified Rankin Scale (mRS) was used to assess their 3-month prognosis, and a multivariate logistic regression model was established to explore risk factors for poor prognosis. Results Multivariate logistic regression analysis demonstrated that NLR (OR=2.114; 95% CI: 1.129–3.959) and baseline National Institute of Health Stroke Scale (NIHSS; OR=1.288, 95% CI: 1.053–1.574) score were risk factors of poor prognosis. The area under the receiver operator characteristic (ROC) curve of NLR in predicting the 3-month outcome after onset was 0.717 (95% CI: 0.606–0.828, P <0.000). The optimal cut-off value was 3.22, with a sensitivity of 0.743 and a specificity of 0.791. Conclusion NLR is an independent risk factor for the poor prognosis of CICAO patients complicated by cerebral infarction and can serve as an indicator for clinical prognosis.

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Neutrophil-to-Lymphocyte Ratio Better Than High-Sensitivity C-Reactive Protein in Predicting Stroke-Associated Pneumonia in Afebrile Patients

Cited by 9 publications

References 41 publications

High Neutrophil-to-Lymphocyte Ratio Predicts One-Year Risk of Pneumonia Post-Stroke Discharge

High Neutrophil-to-Lymphocyte Ratio Predicts One-Year Risk of Pneumonia Post-Stroke Discharge

Predictive value of the systemic immune inflammation (SII) index for stroke‐associated pneumonia

Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients with Chronic Internal Carotid Artery Occlusion Complicated by Cerebral Infarction

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