Systemic Inflammation Biomarkers Ratio as Predictors of Clinical Outcomes in Ischemic Stroke

Abstract

Background: Strokes are among the major causes of disabilities worldwide. In recent years, there has been considerable interest in evaluating stroke prognoses. Objectives: In this investigation, we studied the association of lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ESR-CRP ratio (ECR) with 3 months outcomes among those with acute ischemic stroke (AIS). Materials & Methods: We carried out the present cross-sectional investigation among AIS patients at an academic hospital in northern Iran (from 2019 to 2021). Within 24 hours after the onset of symptoms, laboratory and clinical data of the patients were obtained. We assessed the results using the modified rankin scale (mRS) 90 days after the initial assessment. Statistical significance for comparing descriptive data was determined as P<0.05. Results: We entered 341 participants (Mean±SD age: 69.10±13.55 years, 53.1% female) into this investigation. Based on univariate analysis, there were poor correlations between NLR (r=0.361, P<0.001), PLR (r=0.215, P<0.05), CRP (r=0.234, P<0.001), LMR (r=-0.184, P<0.05), and ECR (r=-0.191, P<0.05) and a 3-month mRS. Also, after three months, the NLR, PLR, and CRP values were higher in the patients who died, but the LMR (P<0.001) and ECR (P<0.05) were lower. In multivariate comparison, only ECR was independently higher among the participants who died within 3 months (P<0.05). Conclusion: In this study, ECR within 24 hours of symptoms onset was related to functional outcomes and mortality at 3-month follow-up. Thus, ECR might provide valuable prognostic information at a relatively low cost.

Keywords

• ischemic stroke
• patient outcomes assessment
• leukocyte counts
• c-reactive protein
• blood sedimentation