The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke

Abstract

Background We aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), platelet-to-white blood cell ratio (PWR) and 90-day mortality in patients with acute ischemic stroke (AIS). Methods We retrospectively included 633 patients with AIS from January 2017 to May 2018. The correlation between each indicator and the degree of neurologic deficit was assessed. Kaplan-Meier survival curves based on blood cell ratios were used to analyze the 90-day survival rate of patients with AIS. Results A total of 663 patients with AIS were enrolled, of which 24 (3.6%) experienced recurrence and 13 (2.0%) died. NLR>3.23 (odds ratio; OR = 2.236; 95% confidence interval [CI], 1.472-3.397; P<0.001), PNR<31.14 (OR = 0.471; 95% CI, 0.297-0.749; P = 0.001), and PWR<20.62 (OR = 0.498; 95% CI, 0.309-0.800; P = 0.004) were associated with an unfavorable 90-day prognosis. NLR>3.23, PWR<20.62, and PNR<31.14 were associated with an increased risk of 90-day mortality. Conclusion PNR, PWR, and NLR were associated with the 90-day mortality of patients with AIS. Patients with high NLRs or low PWRs and PNRs may have a greater risk of mortality than other patients. These clinical indicators may help clinicians judge unfavorable prognosis early and implement the appropriate interventions.

Combined Effect of White Blood Cell and Platelet Count for Predicting In-Hospital Mortality and Pneumonia in Acute Ischemic Stroke

“…While the relationship between low PWR and high risk of in-hospital mortality was not signi cant after adjust potential confounders, which indicated combined WBC count and platelet count with cutoff value is better and feasibility in clinical practice. Early two studies 13,14 shown low PWR was associated with high risk of 90 days mortality and poor outcome, which different with our study. Different outcomes de nition, different study sample size and different cofounders in the models may cause the difference ndings.…”

“…A study of 168 AIS patients given thrombolysis treatment indicated patients with low PWR was associated with poor outcome at 90 days 13 . Cao et al study enrolled 633 AIS patients shown low PWR as well as other marker were increased the risk of 90 days mortality 14 . In present large multicenter study, we found the combined effect of high WBC count and low platelet count on in-hospital mortality.…”

“…In addition, we tested the discriminatory ability of WBC count and platelet count (combined and separately) to predict inhospital mortality and pneumonia by calculating C-statistics (areas under ROC curves). Moreover, we also performed sensitivity analyses based on quartiles of platelet to white blood cell count ratio (PWR), which de ned by the count ratio of platelets to white blood cell 13,14 . All P values were two-tailed, and a signi cance level of 0.05 was used.…”

“…Yang et al study of 101527 AIS patient with thrombolysis treatment found the baseline platelet < 150 *10 9 /L was associated with higher in-hospital mortality and a higher incidence of intracranial hemorrhage 6 . For the signi cant interaction between platelets and WBC on regulation of both hemostatic and in ammatory processes 9 , two studies seen the combined effect of platelets and WBC for predict clinical outcome among AIS patients 13,14 . A study of 168 AIS patients given thrombolysis treatment indicated patients with low PWR was associated with poor outcome at 90 days 13 .…”

“…Given that, maybe there was a combine effect of platelets and WBC for predict clinical outcome. Two studies have noted that the baseline low platelet to white blood cell ratio (PWR) was increased the risk of 90 days poor outcome and mortality 13,14 . However, whether there was a combine effect of platelets and WBC on in-hospital mortality still uncertain.…”