Title: Relationship between Neutrophil Lymphocyte Ratio and Prognosis in Acute Ischemic Stroke
Authors: Dr Narra Lavanya, Dr Yogitha C, Dr Anil Kumar. S, Dr Deepika Somapur
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.113
Abstract
Aims and Objectives: Stroke is the second leading cause of death worldwide and mostly presents acutely. This study was done to determine the relationship between neutrophil lymphocyte ratio (NLR) and acute ischemic stroke and to establish whether neutrophil-lymphocyte ratio can be used as a prognostic marker in acute ischemic stroke.
Materials and Methods: This retrospective study included a total of 100 patients, who presented to the Medicine Department at KIMS hospital, with cerebrovascular accident. Demographic characteristics and comorbidities of patients were recorded. GCS and NIHSS (The National Institutes of Health Stroke Scale) scores were calculated at admission. A hemogram from peripheral venous blood samples was taken at the time of admission. Neutrophil lymphocyte ratio was calculated as the ratio of neutrophils to lymphocytes.
Results: In our study among the 100 patients, 63 were male and 37 were female. The mean NLR was 2.57, 4.28 and 7.36 respectively in mild, moderate and severe categories of GCS, at admission. The mean NLR was 1.63, 3.14, 5.66, 8.8 in mild, moderate, moderate to severe and severe categories of NIHSS respectively, at admission. When the linear relationships of NLR with other continuous variables were examined, the NIHSS score and the GCS had a strong positive correlation with the NLR (P =0.001).The median NLR was significantly increased among the mortality group compared with the survival group. Also the NLR was higher than the normal value in stroke patients.
Conclusion: The NLR at the time of hospital admission may be a predictor of mortality in acute stroke patients. Because of its routine use, low cost and easy-to-measure nature, NLR can be used for prediction of short-term prognosis and in-hospital mortality in stroke patients.
Keywords: Neutrophil-lymphocyte ratio (NLR), Glasgow Coma scale (GCS), NIHSS (The National Institutes of Health Stroke Scale).
