Abstract TP205: Associations Of Admission And Follow-up Neutrophil-lymphocyte Ratios With Clinical Outcomes In Patients With Ischemic Stroke Undergoing Endovascular Therapy

Abstract

Introduction: Neutrophil-lymphocyte ratios (NLRs) can be used to assess inflammatory status, with higher NLRs indicating inflammation and physiologic stress. NLRs after ischemic stroke have been shown to predict both short- and long-term outcomes. Methods: This was a retrospective study of adult patients admitted to a high-volume stroke center in 1/1/2018-12/31/2020 for ischemic stroke who underwent endovascular therapy (ET). The primary outcomes were successful reperfusion (TICI score ≥2B), favorable discharge NIH Stroke Scale/Score (NIHSS≤4), and favorable discharge and 3-month modified Rankin Scale (mRS≤2) scores. The primary predictor was neutrophil-lymphocyte ratio (NLR), measured at admission and throughout the hospital stay, as well as change in NLR between admission and post-ET. Logistic regression and generalized estimating equations assessed associations between NLRs and the outcomes. Results: The study included 131 patients, with a median admission NIHSS of 13 and median discharge NIHSS of 1. Almost all patients (94%) achieved successful reperfusion, and only 2 (1.5%) developed symptomatic ICH. The median discharge mRS was 3, and the median 3-month mRS was 2. The median admission NLR was 6.5 (range 0.8-18.0), and the median NLR change (admission to first post-ET) was 0.0 (range -13.8 to 12.0). Each 1-unit increase in admission NLR was associated with a 19% decreased odds of successful perfusion, 16% decreased odds of favorable discharge NIHSS, 15% decreased odds of favorable discharge mRS, and 14% decreased odds of favorable 3-month mRS. Higher post-ET NLRs on various days were also associated with decreased odds of favorable outcomes (Table 1). Conclusions: Admission and select follow-up NLRs were predictive of successful reperfusion and condition at discharge and at 3-months post-discharge in this patient population. These results show that NLRs, a readily available biomarker, can identify individuals at risk for poor outcomes after ET.