title: Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume?
abstract: BACKGROUND
  Neutrophil/lymphocyte ratio (NLR) is related with increased mortality in both myocardial infarction and acute ischemic stroke. It remains unclear whether NLR is a simple marker of ischemic infarct volume or an independent marker of stroke mortality. The aim of this study is to investigate the relationship of NLR with infarct volume and short-term mortality in acute ischemic stroke (AIS).
  
  
  METHODS
  This retrospective study included 151 patients with first AIS that occurred within 24 hours of symptom onset. Patients were screened from the hospital's electronic record system by using International Classification of Diseases code (G 46.8). NLR was calculated as the ratio of neutrophils to lymphocytes. Short-term mortality was defined as 30-day mortality.
  
  
  RESULTS
  A total 20 of 151 patients died during follow-up. Both NLR and infarct volume of nonsurvived group were significantly higher than survived group (P < .05). Infarct volume, NLR, and National Institutes of Health Stroke Scale (NIHSS) were independent predictors of the mortality in Cox regression analysis. The optimal cutoff value for NLR as a predictor for short-term mortality was determined as 4.81. NLR displayed a moderate correlation with both NIHSS and Glasgow Coma Scale (P < .01). NLR values were significantly higher in the highest infarct volume tertile than both in the lowest volume tertile and midtertile of infarct volume (P = .001).
  
  
  CONCLUSIONS
  NLR at the time of hospital admission maybe a predictor of short-term mortality independent from infarct volume in AIS patients. NLR should be investigated in future prospective trials investigating AIS.
authors.affiliation: Department of Neurology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Tokgoz
authors.affiliation: Department of Radiology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey. Electronic address: drsuatkeskin@yahoo.com.
authors.forename: Suat
authors.initials: S
authors.lastname: Keskin
authors.affiliation: Department of Cardiology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.affiliation: Department of Neurology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Seyithanoglu
authors.affiliation: Department of Cardiology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ogmegul
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D038801:International Classification of Diseases; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood* / Q000401:mortality*
keywords: Neutrophil/lymphocyte ratio; acute; diffusion imaging; ischemic; magnetic resonance imaging; stroke