NLR and LMR could powerfully predict unfavorable outcomes in patients with acute anterior circulation large vessel occlusion stroke (ALVOS) who underwent mechanical thrombectomy.

INTRODUCTION

To investigate the predictive value of Neutrophil to lymphocyte ratio (NLR) and Lymphocyte to monocyte ratio (LMR) on unfavorable outcomes of acute anterior circulation large vessel occlusion stroke (ALVOS) in patients who underwent mechanical thrombectomy (MT).

MATERIAL & METHOD: We retrospectively recruited 96 cases with ALVOS who underwent MT. These cases were divided into two groups including the favorable outcome group (3-month modified Rankin Scale scores (mRS) of 0-2) and the unfavorable outcome group (3-month mRS of 3-6). Logistic regression analysis was used to examine the independent risk factors of the 3-month unfavorable outcome of ALVOS. Moreover, we conducted a receiver operating characteristic curve (ROC) to estimate the valuable predictor of NLR, LMR, and the combination of NLR and LMR on unfavorable outcomes of ALVOS after MT.

RESULTS

46.9 % (45/96) cases had an unfavorable outcome and 53.1 % (51/96) cases had a favorable outcome. In the univariate regression analysis, baseline NIHSS score, symptomatic intracranial hemorrhage, and fasting glucose were included in the multi-factor binary logistic regression, and this revealed that NLR (OR 3.776, 95 %CI 1.067-13.363, p = 0.039) and LMR (OR 0.092, 95 %CI 0.017-0.0506, p = 0.006) were independent predictors of unfavorable outcomes (mRS score 3-6) at 3-month. Higher NLR (> 2.984) and lower LMR (< 3.775) were independently associated with unfavorable outcomes, and the combined predictive levels of both NLR and LMR (AUC = 0.941) were higher than single indicators (NLR, AUC = 0.876; LMR, AUC = 0.934).

CONCLUSIONS

The combination of NLR and LMR was a more powerful predictor of unfavorable outcomes of ALVOS after MT than NLR alone.