title: Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke.
abstract: BACKGROUND
  Neutrophil-to-lymphocyte ratio is an independent predictor of mortality in patients with acute ischemic stroke. However, it is uncertain whether neutrophil-to-lymphocyte ratio is related with functional outcome and recurrent ischemic stroke. In this study, we aimed to investigate the relationship of neutrophil-to-lymphocyte ratio with stroke severity, functional outcome, and recurrent ischemic stroke after acute ischemic stroke.
  
  
  METHODS
  A total of 280 patients with acute ischemic stroke were included in the study. Patients were divided into 3 groups according to the neutrophil-to-lymphocyte ratio value (<2, 2-3, >3). Demographic, clinical, and laboratory data were collected for all patients. We evaluated the association between neutrophil-to-lymphocyte ratio and (1) stroke severity on admission, (2) functional outcome at 3 months, and (3) recurrent ischemic stroke. Regression analyses were performed, adjusting for confounders.
  
  
  RESULTS
  After adjustment for potential confounders, neutrophil-to-lymphocyte ratio was associated with an increased risk of stroke severity on admission (odds ratio [OR] 1.364, 95% confidence interval [CI] 1.101-1.690, P = .005) and primary unfavorable outcome (OR 1.455, 95% CI 1.083-1.956, P = .013). After a median of 1.13 years (interquartile range.91-1.42) of follow-up, neutrophil-to-lymphocyte ratio was associated with recurrent ischemic stroke after adjustment (hazard ratio 1.499, 95% CI 1.161-1.935, P = .002).
  
  
  CONCLUSIONS
  Our study suggests that neutrophil-to-lymphocyte ratio is associated with stroke severity on admission, primary unfavorable functional outcome, and recurrent ischemic stroke in patients with acute ischemic stroke.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Wensi
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Zhengyi
authors.initials: Z
authors.lastname: Cai
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Tieer
authors.initials: T
authors.lastname: Yu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China. Electronic address: shaobei56@126.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Shao
mesh_terms: D000368:Aged; D001786:Blood Glucose; D002545:Brain Ischemia / Q000150:complications*; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D004562:Electrocardiography; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008214:Lymphocytes; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D001786:Blood Glucose; D008074:Lipoproteins; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: Neutrophil-to-lymphocyte ratio; acute ischemic stroke; inflammation; prognosis