Neutrophils/lymphocytes index compared to mean platelets volume/platelets count index, as long hospital stays and survival indicator of stroke. How much is little?

Abstract

Introduction: Stroke is one of the main causes of disability in elderly, and the main cause of neurological emergencies. Mean platelet volume (MPV) has a positive correlation with prothrombotic diseases, highlighting thrombotic events and venous thrombosis disease. Aim: We aim to determine the relation between neutrophil/lymphocyte (N/L) index and MPV/platelet count (PC) index with prognosis in cerebral vascular events in the Mexican population. Methods: We included 236 patients with 137 males (74-78 years) and 81 females (64-72 years); 58 hemorrhagic cases, 44 parenchymal, eight subarachnoid, and 6 subdural; 160 ischemic cases, including 149 ischemic, 2 lacunar, and 9 Transient Ischemic Attack (TIA). All patients had brain imaging, initial, and follow-up hematic cytometry to determine indexes and compare it between them. Results: Neutrophils/lymphocytes index lower than 3 (p = 0.015) and MPV/PC index higher than 0.031 (p = 0.001) increase significantly in stroke during the first 48 h. MPV > 10 fl increase mortality (p = 0.014); considering all strokes; receiver operating characteristic curve showed AUC values of MPV/PC 0.822 (0.760-0.885) (p = 0.001) and N/L 0.661 (0.579-0.742) (p = 0.001) with a significant difference between AUC values (p = 0.001). Conclusions: In our study, mortality rises in patients over 70 years old, especially in hemorrhagic events, females; and patients with higher N/L and MPV/PC indexes. The MPV/ PC is better at predicting severity and long hospital stay in stroke compared to the N/L index. The high platelets levels are related to stroke as well as other studies before; however, this is related to the worst prognosis, increasing mortality and long hospital stay in our population.

Keywords

• Mean platelet volume. Neutrophils lymphocytes ratio. Neutrophils/lymphocytes. Stroke. Mortality.