医学
冲程(发动机)
前瞻性队列研究
内科学
接收机工作特性
列线图
队列
中性粒细胞与淋巴细胞比率
糖尿病
急诊医学
淋巴细胞
机械工程
工程类
内分泌学
作者
Medha Sharath,Ramya B Siddegowda,Ashwini Lonimath,Janardhan D Cheluvaiah
出处
期刊:Cureus
[Cureus, Inc.]
日期:2022-11-11
摘要
Introduction Cerebrovascular accidents or strokes are a major cause of mortality and morbidity in today's world. Post-stroke disabilities like paralysis, dementia, etc., can affect the quality of life of patients as well as their families. A combined increase in neutrophils and a decrease in lymphocytes during inflammation in stroke manifests as an elevated neutrophil-to-lymphocyte ratio (NLR), thereby indicating the severity of neural damage. Aim We aimed to determine if an elevated NLR observed on the day of hospital admission can predict a higher risk of in-hospital mortality in stroke patients. Confirmatory results could aid in developing risk stratification for management, ultimately improving clinical and functional outcomes. Materials and methods Sixty stroke patients were monitored throughout their hospital stay in this prospective cohort study. NLR was calculated at admission using routine complete blood counts. The data were analyzed using SPSS Software v23.0 (IBM Corp., Armonk, NY). An unpaired t-test was used to compare the means between the two groups. Categorical data were analyzed using the chi-square test. The receiver operating curve (ROC) was plotted and used to ascertain if a cut-off value of NLR could be obtained to predict in-hospital mortality in stroke patients. P values <0.05 were considered statistically significant. Results About 23.3% (n=14) of the patients died during their hospital stay, with no significant differences between the survivor and death cohorts in terms of comorbidities like diabetes and hypertension. The mean NLR calculated within 24 hours of hospital admission in patients who died (NLR=8.47 (standard deviation (SD)=4.67)) was significantly higher (p=0.009) than in those who survived (NLR=5.84 (SD=2.62)). Upon ROC analysis, patients with NLR >6.03 on the day of admission demonstrated a higher risk of in-hospital mortality (p=0.015 (95% CI: 0.577-0.855)). An area under the curve (AUC) of 0.72 with a sensitivity of 92.86% and a specificity of 54.35% was obtained. Conclusions Elevated NLR (cut-off >6.03) obtained within 24 hours of hospital admission is an indicator of a higher risk of in-hospital mortality in stroke patients. Hence, patients presenting with a high NLR at admission can be prioritized for personalized targeted treatment, potentially reducing mortality and post-stroke complications.
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