Prognostic Significance of Various Inflammation-Based Scores in Patients with Mechanical Thrombectomy for Acute Ischemic Stroke

Abstract

The objective of this study was to assess the relationship between inflammation-based scores and prognosis of patients who had undergone mechanical thrombectomy (MT) for large artery occlusion. A total of 411 patients were enrolled and inflammation-based scores, such as neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), and monocyte/high-density lipoprotein cholesterol ratio (MHR) were calculated based on laboratory data. Prognoses were evaluated with unfavorable outcome (modified Rankin Scale score of 3-6), symptomatic intracranial hemorrhage, hemorrhagic transformation of infarct, and mortality. Multivariate analyses were performed to explore the relationships of inflammation-based scores with various clinical outcomes. Patients with unfavorable outcome showed higher mean NLR and MHR but lower mean LMR than those with favorable outcome (NLR, 7.32 vs. 3.78, P ≤ 0.001; MHR, 1.42 vs. 1.15, P= 0.012; LMR, 2.76 vs. 3.70, P= 0.003). In multivariate analysis, higher NLR (≥5.1) (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.04-2.12; P= 0.014) and higher MHR (≥1.4) (OR, 1.32; 95% CI, 1.10-1.74; P= 0.028), lower LMR (<2.5) (OR, 1.28; 95% CI, 1.08-1.58; P= 0.032) were independently associated with unfavorable outcome. After MT, higher NLR, higher MHR, and lower LMR were found in patients with unfavorable outcome. Inflammation-based scores, such as NLR, LMR, and MHR, might be independent factors that can predict outcomes in patients with MT.