Deans' stroke musings: High Neutrophil-to-Lymphocyte Ratio Predicts Stroke-Associated Pneumonia

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, July 3, 2018

High Neutrophil-to-Lymphocyte Ratio Predicts Stroke-Associated Pneumonia

Hopefully your doctor has protocols for testing all the possible sequelae from a stroke. Then s/he needs rehab protocols for all the sequelae. But there will be none, you are completely on your own to figure out how to recover. Your doctor won't tell you that but it is true.

High Neutrophil-to-Lymphocyte Ratio Predicts Stroke-Associated Pneumonia

Ki-Woong Nam, Tae Jung Kim, Ji Sung Lee, Hyung-Min Kwon, Yong-Seok Lee, Sang-Bae Ko, Byung-Woo Yoon

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https://doi.org/10.1161/STROKEAHA.118.021228

Stroke. 2018;STROKEAHA.118.021228

Originally published July 2, 2018

Abstract

Background and Purpose—Although there are a variety of risk factors and predictive models for stroke-associated pneumonia (SAP), more objective and easily accessible markers are still needed. In this study, we evaluated the relationship between the neutrophil-to-lymphocyte ratio (NLR) and SAP in patients with acute ischemic stroke.

Methods—We assessed 1317 consecutive patients with acute ischemic stroke. SAP was defined according to the modified Centers for Disease Control and Prevention criteria. The severity of pneumonia was rated using scores from the Pneumonia Severity Index, the quick Sequential Organ Failure Assessment, and the Acute Physiology and Chronic Health Evaluation II. The NLR was calculated after dividing absolute neutrophil counts by absolute lymphocyte counts.

Results—Among the total patients, SAP occurred in 112 (9.0%) patients. Using a multivariable analysis, the NLR (adjusted odds ratio=1.55; 95% confidence interval, 1.15–2.11; P=0.005) remained significant after adjusting for confounders. In addition, age, atrial fibrillation, previous stroke history, initial National Institutes of Health Stroke Scale score, and high-sensitivity C-reactive protein were also significant, independent of NLR. The NLR was higher in the severe pneumonia group when it was assessed by Pneumonia Severity Index (P<0.001), and Acute Physiology and Chronic Health Evaluation II scores (P=0.004). Furthermore, patients who had SAP had worse clinical outcomes both during hospitalization and after discharge.

Conclusions—We demonstrated that a higher NLR predicted SAP in patients with acute ischemic stroke. The NLR may help to identify high-risk patients in time and provide clues for further studies about preventive antibiotic therapy.

infection

inflammation

lymphocyte

neutrophils

pneumonia

prognosis