Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke

Xue, Jing; Huang, Wenxi; Chen, Xiaoli; Li, Qian; Cai, Zhenzhen; Yu, Tieer; Shao, Baiqi

doi:10.1016/j.jstrokecerebrovasdis.2016.11.010

Cited by 181 publications

(179 citation statements)

References 41 publications

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“…Furthermore, the NLR has been reported to be an independent risk factor for the incidence of AIS in generally healthy populations [2]. In our study, the NLR and the total WBC count were significantly higher in the poor outcome group than in the good outcome group, similar to results reported in other studies [23,24,[32][33][34]. This result remains significant even after adjustment for various potential confounders.…”

Section: Discussionsupporting

confidence: 90%

“…In physiological conditions, the blood brain barrier (BBB) controls the entry of immune cells into the brain. However, the entry of neutrophils is enhanced by a local BBB breakdown induced by ischemia [12,34,35]. Perivascular neutrophil migration into the intraparenchymal area occurs within 6 to 24 hours [35,36].…”

Section: Discussionmentioning

confidence: 99%

“…Lately, the NLR has been reported as an independent predictor of the severity and mortality of acute coronary syndrome [17][18][19][20][21][22][23]. Several studies have supported the hypothesis that the NLR is an independent factor for predicting short-term mortality and unfavorable functional outcome in AIS [23,24,32,34,41]. Tokgoz et al reported that the NLR at the time of hospital admission might be a predictor of short-term mortality independent of infarct volume in patients with AIS [42].…”

Section: Discussionmentioning

confidence: 99%

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Neutrophil to Lymphocyte Ratio Predicts Short-Term Functional Outcome in Acute Ischemic Stroke

2017

ARC Journal of Neuroscience

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neutrophil to Lymphocyte Ratio Predicts Short-Term Functional Outcome in Acute Ischemic Stroke

2017

ARC Journal of Neuroscience

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“…Ischemic stroke is associated with high rates of mortality and morbidity [4]. The subsequent inflammatory reaction involves cytokine release and recruitment of inflammatory cells.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, it is used to predict the prognosis of patients with various cancers [10,11], cardiovascular diseases [12,13] and hemorrhagic stroke [14][15][16]. Recently, NLR was used to predict in-hospital mortality [17,18], 90-day mortality [19][20][21] and 90-day poor outcomes (mRS≥3) [4,[21][22][23] in patients with ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

Ye¹,

Ai²,

Fang³

et al. 2017

Oncotarget

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Objective: Neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory biomarker in patients with cardiovascular disease and hemorrhagic stroke. This metaanalysis aims to evaluate the prognostic values of NLR in predicting clinical outcomes in patients with ischemic stroke.Methods: A literature search was performed using the databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure. Two reviewers independently retrieved papers that met the inclusion criteria. Subgroup analyses were performed using in-hospital mortality, 90-day mortality and 90-day poor outcomes (mRS>2) as the outcome measures.Results: Eight studies with 3855 patients were included in the analysis. An elevated NLR was a strong predictor for in-hospital mortality (OR: 1.05; 95% CI: 1.03-1.07, p<0.001) and for 90-day poor outcomes (OR: 2.28; 95% CI: 1.39-3.73, p<0.001), but not for 90-day mortality (OR: 3.04; 95% CI: 0.74-12.55, p=0.12). After performing subgroup analysis, the NLR was found to predict 90-day mortality with a high (>5) cut-off values (OR: 6.69; 95% CI: 1.70-26.33, p=0.007). The lower cut-off values had no significance (OR: 2.17; 95% CI: 0.43-10.86, p=0.35).Conclusions: A high NLR was significantly associated with higher rates of inhospital mortality and 90-day poor outcome in patients with ischemic stroke, especially with a high mean NLR or high cut-off values. With a high cut-off value (>5), NLR could predict the 90-day mortality after ischemic stroke.

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Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Zhang

Xiao-dong

et al. 2019

Brain and Behavior

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Introduction The neutrophil‐to‐lymphocyte ratio (NLR) has been shown to be a marker associated with inflammation and is independently associated with the adverse clinical outcomes of symptomatic intracranial hemorrhage, cancer, and cardiovascular disease. Hemorrhagic transformation (HT) is a serious complication of ischemic cerebral infarction and can be intensified by therapeutic interventions for acute ischemic stroke (AIS). The purpose of our research was to explore the predictive effect of NLR for HT in patients with AIS and to determine the best predictive value. Methods PubMed, Web of Science, EMBASE, MEDLINE, Cochrane, and Google Scholar were searched. The primary endpoint was HT, and subgroup analysis was performed. Review Manager software version 5.3 was used to statistically analyze the outcomes. Results A total of seven studies including 3,726 patients met the inclusion criteria. The pooled odds ratio (OR) value of the high NLR that predicted HT in AIS patients was 1.53 (95% CI, 1.21–1.92; p = .0003). In addition, 1.10 (95% CI, 1.05–1.15; p < .0001) was the pooled OR of the high NLR associated with increased 3‐month mortality in patients with AIS. In the subgroup analysis with an NLR cutoff value of 7.5–11, the correlation between NLR above the cutoff value and the rate of HT in patients with AIS was statistically significant (OR, 7.93; 95% CI, 2.25–27.95; p = .001). Conclusion A high NLR can predict HT and 3‐month mortality in patients with AIS. Regardless of the country of origin and the sampling time, an NLR with a cutoff value of 7.5–11 was independently associated with HT in AIS patients.

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Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke

Cited by 181 publications

References 41 publications

Neutrophil to Lymphocyte Ratio Predicts Short-Term Functional Outcome in Acute Ischemic Stroke

Neutrophil to Lymphocyte Ratio Predicts Short-Term Functional Outcome in Acute Ischemic Stroke

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

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