Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Older Patients with Acute Ischemic Stroke.

BACKGROUND: The prognostic value of the neutrophil-to-lymphocyte ratio (NLR), an inflammatory indicator, for 90-day outcomes has not been determined for patients with acute ischemic stroke aged ≥ 80 years. Therefore, this study examined the predictive significance of the NLR for estimating the 90-day outcomes of older patients with acute ischemic stroke.

METHODS: Data from patients aged ≥ 80 years were recorded within 7 days of ischemic stroke onset during the period from January 2019 to June 2021. A Kaplan-Meier curve was drawn based on the incidence of adverse outcomes to compare the survival probability of each group at different time periods. Cox multivariate regression was used to explore adverse events affecting patient prognosis.

RESULTS: A total of 560 patients were initially recruited; of these, 476 were eligible for inclusion. The log-rank test showed that the survival rates of the groups differed. The 90-day survival rate was significantly lower in the group with the highest NLR than in the group with the lowest NLR. Multivariate Cox regression analysis showed that after adjusting for risk factors, a high NLR and a high National Institutes of Health Stroke Scale score were independent risk factors for 90-day mortality. According to the receiver operating characteristic analysis, the area under the curve for predicting mortality at 90 days was 0.74.

CONCLUSION: This study confirmed that a high NLR is an independent risk factor for acute ischemic stroke and has predictive value for 90-day prognosis in patients aged ≥ 80 years.