Xu Maoxia, Zhai Qian, Wei Bin, Chen Shuaiyu, E Yan, Huang Zhihang, Qi Jinwen, Xu Yiming
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
Ther Clin Risk Manag. 2025 Apr 26;21:565-573. doi: 10.2147/TCRM.S519263. eCollection 2025.
The neutrophil percentage-to-albumin ratio (NPAR) is connected with all-cause mortality and stroke-related pneumonia. The purpose of this study was to assess the diagnostic efficacy of NPAR in predicting functional outcomes at 90 days after endovascular thrombectomy (EVT).
We retrospective analyzed consecutive patients who underwent EVT at Nanjing First Hospital from October 2019 to June 2024. NPAR was defined as the percentage of neutrophils divided by the albumin levels. An unfavorable outcome was indicated by a modified Rankin Scale score of 3-6 at 90 days. Multivariable logistic regression models were utilized to investigate the association between NPAR and functional outcomes after EVT treatment.
A total of 713 patients (mean age, 70.5 ± 11.9 years; 430 males) were finally enrolled for analysis. Among these, 357 (50.1%) patients exhibited unfavorable outcomes at 90 days. Multivariate regression analysis indicated that elevated NPAR levels at admission were independently associated with poor outcome (adjusted odds ratio: 6.921; 95% confidence interval, 4.216-11.363; 0.001) in ischemic stroke patients undergoing EVT. Furthermore, the restricted cubic spline observed a positive and nonlinear association between the NPAR and poor outcome at 90 days ( for linearity=0.001).
This study indicated that higher NPAR levels were associated an increased risk of poor outcome at 90 days in patients treated with EVT, suggesting that NPAR could serve as a viable prognostic biomarker for ischemic stroke after EVT.
中性粒细胞百分比与白蛋白比值(NPAR)与全因死亡率及卒中相关性肺炎相关。本研究旨在评估NPAR对血管内血栓切除术(EVT)后90天功能结局的诊断效能。
我们回顾性分析了2019年10月至2024年6月在南京第一医院接受EVT的连续患者。NPAR定义为中性粒细胞百分比除以白蛋白水平。90天时改良Rankin量表评分为3 - 6分表明预后不良。采用多变量逻辑回归模型研究NPAR与EVT治疗后功能结局之间的关联。
最终纳入713例患者进行分析(平均年龄70.5±11.9岁;男性430例)。其中,357例(50.1%)患者在90天时出现不良结局。多因素回归分析表明,接受EVT的缺血性卒中患者入院时NPAR水平升高与不良结局独立相关(调整比值比:6.921;95%置信区间,4.216 - 11.363;P = 0.001)。此外,受限立方样条显示NPAR与90天时的不良结局呈正相关且为非线性关系(线性检验P = 0.001)。
本研究表明,接受EVT治疗的患者中,较高的NPAR水平与90天时不良结局风险增加相关,提示NPAR可作为EVT后缺血性卒中可行的预后生物标志物。