Impact of peripheral lymphocyte subsets on prognosis for patients after acute ischemic stroke: A potential disease prediction model approach.

AIMS

To investigate the relationship between peripheral blood lymphocyte subsets and prognosis in patients with acute ischemic stroke (AIS).

METHODS

We enrolled 294 patients with AIS and collected peripheral blood samples for analysis of lymphocyte subsets. Prognosis was assessed at 3 months using the modified Rankin Scale (mRS). Association between lymphocyte count and poor outcomes (mRS score >2) was assessed using logistic regression. Individualized prediction models were developed to predict poor outcomes.

RESULTS

Patients in the mRS score ≤2 group had higher T-cell percentage (odds ratio [OR] = 0.947; 95% confidence interval [CI]: 0.899-0.998; p = 0.040), CD3 T-cell count (OR = 0.999; 95% CI: 0.998-1.000; p = 0.018), and CD4 T-cell count (OR = 0.998; 95% CI: 0.997-1.000; p = 0.030) than those in the mRS score >2 group 1-3 days after stroke. The prediction model for poor prognosis based on the CD4 T-cell count showed good discrimination (area under the curve of 0.844), calibration (p > 0.05), and clinical utility.

CONCLUSION

Lower T cell percentage, CD3, and CD4 T-cell counts 1-3 days after stroke were independently associated with increased risk of poor prognosis. Individualized predictive model of poor prognosis based on CD4 T-cell count have good accuracy and may predict disease prognosis.