Abstract TP229: High Neutrophil-to-Lymphocyte Ratio Predicts Early Neurological Deterioration in Ischemic Stroke Patients

Abstract

Introduction: Ischemic stroke patients experienced frequent early neurological deterioration (END) events. Since ischemic stroke has also been shown as inflammatory disease, the neutrophil-to-lymphocyte ratio (NLR) may associated with END events. However, the direct study regarding this association has not been addressed. Hypothesis: We evaluated the association between NLR and END in ischemic stroke patients. Methods: We included consecutive ischemic stroke patients between 2010 and 2015. END was defined as an increase ≥ 2 on the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 on the motor NIHSS score within 72 hours of admission. The NLR was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count. Results: A total of 1,152 patients were included. END occurred in 154 (13%) patients and the median NLR value was 2.47 [1.59-3.97]. In multivariate analysis, NLR remained an independent predictor of END [adjusted odds ratio (aOR) = 1.071, 95% confidence interval (CI) = 1.025 to 1.119, P = 0.002]. Age, initial thrombolysis treatment, fasting blood sugar, and total cholesterol levels were also significant, being independent of NLR values. These results were more prominent in large artery atherosclerosis group (aOR = 1.107, 95% CI = 1.031 to 1.188, P = 0.005), while stroke patients with small vessel occlusion (aOR = 1.114, 95% CI = 0.895 to 1.387, P = 0.335) or cardioembolic (aOR = 1.028, 95% CI = 0.912 to 1.159, P = 0.649) mechanisms did not show statistical significance. Conclusions: A high NLR level was associated with END in ischemic stroke patients, especially in large artery atherosclerosis patients. The NLR may hep to identify high-risk patients in time and provide clues for further studies about inflammatory pathophysiology of ischemic stroke.