title: Platelet-to-White Blood Cell Ratio: A Prognostic Predictor for 90-Day Outcomes in Ischemic Stroke Patients with Intravenous Thrombolysis.
abstract: BACKGROUND
  This study is aimed to investigate the relationship between platelet-to-white blood cell ratio (PWR) and 90-day outcomes in acute stroke patients with intravenous thrombolysis (IVT).
  
  
  METHODS
  A retrospective analysis was performed on 168 patients receiving IVT for acute ischemic stroke. Complete blood count evaluation was conducted at admission before IVT. A modified Rankin Scale (mRS) score of 3-6 at 90 days was considered an unfavorable outcome.
  
  
  RESULTS
  A total of 168 patients were included from 2013 to 2015. The mean age of the sample was 64.6 (±12.3) years, and 23.2% were women. The median baseline National Institutes of Health Stroke Scale score was 7.5 (interquartile range [IQR] 8.0) and the 90-day mRS score was 2 (IQR 2). In our multivariate logistic regression model, a PWR greater than 23.52 (odds ratio .454, 95% confidence interval: .212-.973, P < .050) was a predictor of 90-day outcomes. In addition, there was a significant difference in the PWR values of patients between favorable outcome and unfavorable outcome in the large-artery atherosclerosis subtype (28.241 ± 11.581 and 21.899 ± 9.107, respectively; P = .005).
  
  
  CONCLUSIONS
  The PWR at admission predicts 90-day outcomes in ischemic stroke patients with IVT. With the easy and routine use of hemogram analysis, the PWR should be investigated in further prospective randomized controlled trials of acute stroke.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Zhibo
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wenyue
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Zhangna
authors.initials: Z
authors.lastname: Ding
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wanhui
authors.initials: W
authors.lastname: Pang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Dehao
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Zhongqian
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Yiyun
authors.initials: Y
authors.lastname: Weng
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: drzhangxu@126.com.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001792:Blood Platelets; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D002681:China; D004185:Disability Evaluation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D007958:Leukocyte Count; D007962:Leukocytes; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010343:Patient Admission; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Outcomes; intravenous thrombolysis; ischemic stroke; platelet-to-white blood cell ratio