Neutrophil-to-Lymphocyte Ratio as a Predictor of Short-Term Functional Outcomes in Acute Ischemic Stroke Patients

Min-Su Kim, Min Young Heo, Hyo Jin Joo, Ga Yang Shim, Jinmann Chon, Sung Joon Chung, Yunsoo Soh () and Myung Chul Yoo ()
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Min-Su Kim: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Min Young Heo: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Hyo Jin Joo: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Ga Yang Shim: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Jinmann Chon: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Sung Joon Chung: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Yunsoo Soh: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
Myung Chul Yoo: Department of Physical Medicine & Rehabilitation, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea

IJERPH, 2023, vol. 20, issue 2, 1-12

Abstract: Background: Neutrophil-to-lymphocyte ratio (NLR), a systemic inflammatory biomarker, has been associated with poorer outcomes in acute ischemic stroke patients. The present study was designed to expand these findings by investigating the association between NLR and short-term functional outcomes in acute ischemic stroke patients. Methods: This retrospective study evaluated patients within 7 days after the onset of acute ischemic stroke. Stroke severity on admission was measured using the National Institutes of Health Stroke Scale (NIHSS). The functional outcomes were assessed using the Berg Balance Scale (BBS), Manual Function Test (MFT), the Korean version of the modified Barthel Index (K-MBI), and the Korean Mini-Mental State Examination (K-MMSE) within 2 weeks of stroke onset. The modified Rankin Scale (mRS) was evaluated at discharge. Results: This study included 201 patients, who were grouped into three NLR tertiles (<1.84, 1.84–2.71, and >2.71) on admission. A multivariate analysis showed that the top tertile group (NLR > 2.71) had significantly higher risks of unfavorable outcomes on the K-MBI ( p = 0.010) and K-MMSE ( p = 0.029) than the bottom tertile group (NLR < 1.84). Based on the optimal cut-off values from a receiver operating characteristic curve analysis, a higher NLR was significantly associated with higher NIHSS scores ( p = 0.011) and unfavorable outcomes on the K-MBI ( p = 0.002) and K-MMSE ( p = 0.001). Conclusions: A higher NLR is associated with poorer short-term functional outcomes in acute ischemic stroke patients.

Keywords: ischemic stroke; neutrophil-to-lymphocyte ratio; modified Barthel Index; MMSE; modified Rankin Scale; NIHSS; outcome assessment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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