Emergency Department, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China.
Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China.
BMC Neurol. 2023 Sep 7;23(1):320. doi: 10.1186/s12883-023-03365-6.
The low-grade inflammation (LGI) score, a novel indicator of chronic LGI, combines C-reactive protein (CRP), leukocyte counts, the neutrophil/lymphocyte ratio (NLR), and the platelet (PLT) count to predict outcomes of patients with various conditions, such as cardiovascular diseases, cancers, and neurodegenerative diseases. However, few studies have examined the role of the LGI score in predicting functional outcomes of patients with ischemic stroke. The present study aimed to evaluate the association between the LGI score and functional outcomes of patients with ischemic stroke.
A total of 1,215 patients were screened in the present study, and 876 patients were finally included in this retrospective observational study based on the inclusion and exclusion criteria. Blood tests were conducted within 24 h of admission. Severity of ischemic stroke was assessed using the NIHSS score with severe stroke denoted by NIHSS > 5. Early neurological deterioration (END) was defined as an increment in the total NIHSS score of ≥ 2 points within 7 days after admission. Patient outcomes were assessed on day 90 after stroke onset using the modified Rankin Scale (mRS).
The LGI score was positively correlated with baseline and the day 7 NIHSS scores (R2 = 0.119, p < 0.001;R2 = 0.123, p < 0.001). Multivariate regression analysis showed that the LGI score was an independent predictor of stroke severity and END. In the crude model, the LGI score in the fourth quartile was associated with a higher risk of poor outcomes on day 90 compared with the LGI score in the first quartile (OR = 5.02, 95% CI: 3.09-8.14, p for trend < 0.001). After adjusting for potential confounders, the LGI score in the fourth quartile was independently associated with poor outcomes on day 90 (OR = 2.65, 95% CI: 1.47-4.76, p for trend = 0.001). Finally, the ROC curve analysis showed an AUC of 0.682 for poor outcomes on day 90 after stroke onset.
The LGI score is strongly correlated with the severity of acute ischemic stroke and that the LGI score might be a good predictor for poor outcomes on day 90 in patients with acute ischemic stroke.
低水平炎症（LGI）评分是一种新型慢性 LGI 标志物，它结合了 C 反应蛋白（CRP）、白细胞计数、中性粒细胞/淋巴细胞比值（NLR）和血小板（PLT）计数，用于预测各种疾病（如心血管疾病、癌症和神经退行性疾病）患者的结局。然而，很少有研究探讨 LGI 评分在预测缺血性脑卒中患者功能结局方面的作用。本研究旨在评估 LGI 评分与缺血性脑卒中患者功能结局之间的关系。
本研究共筛选了 1215 例患者，根据纳入和排除标准，最终有 876 例患者被纳入本回顾性观察性研究。入院 24 小时内进行血液检查。采用 NIHSS 评分评估缺血性脑卒中的严重程度，NIHSS＞5 表示严重脑卒中。早期神经功能恶化（END）定义为入院后 7 天内总 NIHSS 评分增加≥2 分。使用改良 Rankin 量表（mRS）在卒中发病后 90 天评估患者结局。
LGI 评分与基线和第 7 天 NIHSS 评分呈正相关（R2=0.119，p＜0.001；R2=0.123，p＜0.001）。多变量回归分析表明，LGI 评分是脑卒中严重程度和 END 的独立预测因素。在原始模型中，与 LGI 评分第 1 四分位相比，LGI 评分第 4 四分位与第 90 天不良结局的风险更高（OR=5.02，95%CI：3.09-8.14，p 趋势＜0.001）。在调整潜在混杂因素后，LGI 评分第 4 四分位与第 90 天不良结局独立相关（OR=2.65，95%CI：1.47-4.76，p 趋势=0.001）。最后，ROC 曲线分析显示卒中发病后第 90 天不良结局的 AUC 为 0.682。
LGI 评分与急性缺血性脑卒中的严重程度密切相关，LGI 评分可能是预测急性缺血性脑卒中患者第 90 天不良结局的一个较好指标。
