Memiş Zülfikar, Gürkaş Erdem, Özdemir Atilla Özcan, Acar Bilgehan Atılgan, Ögün Muhammed Nur, Aytaç Emrah, Akpınar Çetin Kürşad, Akıl Eşref, Çabalar Murat, Özkul Ayça, Görgülü Ümit, Bayındır Hasan, Mehdiyev Zaur, Delibaş Katı Şennur, Baydemir Recep, Yabalak Ahmet, Önalan Ayşenur, Acar Türkan, Aykaç Özlem, Uysal Kocabaş Zehra, Yıldırım Serhan, Doğan Hasan, Arı Mehmet Semih, Çetiner Mustafa, Balgetir Ferhat, Eren Fettah, Eren Alper, Kızıldağ Nazım, Cenikli Utku, Şişman Bayar Aysel Büşra, Temel Ebru, Akbaş Alihan Abdullah, Saygın Uysal Emine, Gültekin Hamza, Durmaz Cebrail, Boncuk Ulaş Sena, Asil Talip
Department of Neurology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul 34130, Turkey.
Department of Neurology, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, Istanbul 34130, Turkey.
Diagnostics (Basel). 2024 Dec 21;14(24):2880. doi: 10.3390/diagnostics14242880.
The prognostic value of the neutrophil-lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Admission NLR correlated weakly but significantly with both baseline ( = 0.018) and 24 h ( = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not ( = 0.557). Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.
由于各研究中队列的变异性和治疗的异质性，中性粒细胞与淋巴细胞比值（NLR）在缺血性卒中中的预后价值仍存在争议。本研究评估了接受早期成功血管再通治疗的前循环大血管闭塞（LVO）患者入院时的NLR、卒中严重程度与90天预后之间的关系。对1082例接受急性缺血性卒中机械取栓治疗的患者进行了一项回顾性多中心研究。使用逻辑回归分析入院时的NLR、基线美国国立卫生研究院卒中量表（NIHSS）、24小时NIHSS与90天改良Rankin量表（mRS）预后之间的关系。入院时的NLR与基线（P = 0.018）和24小时（P = 0.005）NIHSS评分均呈弱但显著的相关性，反映了卒中的严重程度。然而，多变量分析显示，较高的24小时NIHSS评分（比值比0.831，P = 0.000）和较长的穿刺至再通时间（比值比0.981，P = 0.000）是90天预后不良的独立预测因素，而NLR则不是（P = 0.557）。入院时的NLR与卒中严重程度相关，但对于早期成功实现血管再通的患者，它并不能独立预测90天时的临床结局。这些发现强调了炎症在卒中急性期的关键作用，但表明在这种情况下，其对长期结局的预后价值有限。
