International Journal of General Medicine (Jan 2022)
Neutrophil Albumin Ratio is Associated with All-Cause Mortality in Stroke Patients: A Retrospective Database Study
Abstract
Zhibo Chen,1 Dewei Xie,1 Yun Li,1 Zebin Dai,2 Saina Xiang,2 Zhiyuan Chen,2 Weiqian Zhu1 1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of China; 2College of the First Clinical Medical Sciences of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Weiqian ZhuDepartment of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of ChinaTel +86 577 55579372Fax +86 577 55579318Email [email protected]: The novel biomarker, neutrophil percentage-to-albumin ratio (NPAR), as a prognostic tool for inflammation in relation to all-cause mortality for patients afflicted by strokes has yet to be explored.Methods: Data sets associated with patient files stored within the MIMIC-III V1.4 database were obtained. Data files from 940-patients were obtained for this retrospective analysis. Clinical endpoints were determined to represent a month (30-), three months (90-) and year (365-) all-cause mortality in stroke patients were determined. In order to determine NPAR and clinical endpoint relationships, Cox proportional hazards models were utilized.Results: For all-cause mortality within a 30-day period, in an unadjusted model, the HR (95% CIs) in group B (NPAR 20.5– 25.0) and C (NPAR > 25.0) was 1.17 (0.85, 1.63) and 1.55 (1.13, 2.11) compared with group A (NPAR < 20.5). Proceeding adjustment for more confounding factors, higher NPAR still obtained significant predictive power for 30-day all-cause mortality (HR= 1.45, 95% CI: 1.05, 2.00). Statistical significance (P = 0.0196) was also observed for the other time-based subgroupings for all-cause mortality.Conclusion: A strong correlation was present between increased levels of the novel biomarker NPAR and increased risk of mortality in stroke patients.Keywords: neutrophil-albumin ratio, mortality, stroke, biomarker