I see absolutely no use for this. These predictions are based upon the complete failure of recovery currently. YOUR JOB IS TO CHANGE THOSE FAILURES TO RECOVERY. GET THERE!
Cuiping Chen
†,
Lei Gu†,
Luyun Chen,
Wangwang Hu,
Xiaowen Feng,
Fengzhen Qiu,
Zijian Fan,
Qitao Chen,
Jiayou Qiu and
Bei Shao*
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Objective: Neutrophil-to-lymphocyte
ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been emerging as
the novel inflammatory biomarkers for determining the prognosis of
various diseases. This study aimed to investigate the individual and
joint effects of NLR and PLR on functional outcomes of acute ischemic
stroke (AIS).
Methods: Our study involved 448
eligible patients with first-ever AIS. Clinical and laboratory data were
collected on admission within 72 h from stroke onset. Unfavorable
functional outcome was defined as a modified Rankin Scale score of 3–6
at 3 months after AIS. Cox proportional hazard model and spline
regression models was used to estimate the effect of NLR and PLR on risk
of adverse outcomes after the last patient who completed a 3-months
follow-up was enrolled.
Results: After adjusting confounders, NLR were significantly associated with the unfavorable functional outcomes (P-trend < 0.001). So were PLR (P-trend < 0.001). NLR was discovered to have higher predictive value than PLR (AUC = 0.776, 95%CI = 0.727–0.825, P < 0.001; AUC = 0.697, 95%CI = 0.641–0.753, P
< 0.001). The optimal cutoff values for NLR and PLR was 3.51 and
141.52, respectively. Stratified analysis performed by cox proportional
hazard model showed that high level of NLR and PLR (NLR ≥ 3.51, PLR ≥
141.52) presented the highest risk of unfavorable functional outcomes
(adjusted HR, 3.77; 95% CI: 2.38–5.95; P < 0.001). Followed by single high level of NLR (adjusted HR, 2.32; 95% CI: 1.10–4.87; P
= 0.027). Single high level of PLR (NLR < 3.51, PLR ≥ 141.52) also
showed higher risk than low level of the combination, but it did not
reach statistical significance (adjusted HR, 1.42; 95% CI: 0.75–2.70; P
= 0.285). No obvious additive [relative excess risk due to interaction
(RERI) not significant] or multiplicative (adjusted HR, 0.71; 95%CI:
0.46–1.09; P = 0.114) interaction was found between the effects of NLR and PLR on the risk of unfavorable functional outcomes.
Conclusion: This study demonstrated that
both NLR and PLR were independent predictors of 3-months functional
outcomes of AIS. They may help to identify high-risk patients more
forcefully when combined together.
Introduction
Stroke, the second leading cause of deaths and the third
main malady giving rise to disability worldwide, has brought about a
major drain on public health-care funding (1). The most common subtype of stroke is ischemic stroke, accounting for 80% of all (2).
As China has the highest number of stroke cases in the world with its
incidence and prevalence escalating and sprawling over the past decade (3),
long-term care of the patients laid a immeasurably huge burden on
thousands relatives of patients and caregivers. For this reason,
identifying biomarkers for predicting ischemic stroke and accurately
evaluating its prognosis is salutary and truly preoccupying to the
families.
Post-ischemic inflammation plays an important role in
various stages of cerebral ischemic injury, resulting from stagnant
blood flow, activation of intravascular leukocytes and release of
pro-inflammatory mediators from the ischemic endothelium, platelet
granules, and brain parenchyma (4, 5). Numerous studies confirmed that inflammatory response aggravated ischemic brain damage and neurological dysfunction (4, 6, 7).
Previous researches suggested that leukocytosis on admission was
associated with stroke severity and poor clinical outcomes in acute
ischemic stroke (AIS) patients (8).
High neutrophil count and low lymphocyte count were regarded as
correlation factors of unfavorable functional outcomes of acute cerebral
infarction (9).
Although the relativity between an increasing platelet count and
clinical prognosis remained to be uncertain, it was confirmed that
platelets acted as a pivotal role in thrombogenesis and inflammation (5, 10).
Neutrophil-to-lymphocyte ratio (NLR) and
platelet-to-lymphocyte ratio (PLR) as newfound and inexpensive
biomarkers in systematic inflammation were proved to possess diagnostic
and predictive capabilities in multiple diseases recently (11–13).
Their application in cerebrovascular diseases have been spotlighted by
many. Xue et al. found that NLR in patients with AIS was related to
stroke severity, short-term functional prognosis and recurrence of
cerebral infarction (14). Kocaturk et al. believed that NLR could portend short-term mortality in patients with AIS (15).
Altintas et al. elucidated that high PLR augmented the infarct volume
and the incidence of undesirable prognosis in AIS patients during
3-years follow up (16).
Lately, The joint application of NLR and PLR for predicting clinical
prognosis has been universally applied to patients with cancer, coronary
artery disease, and subarachnoid hemorrhage (17–19).
However, to the best of our knowledge, there has been no data
supporting the significance of the joint effects of NLR and PLR on
short-term functional outcomes of AIS. Therefore, the aim of this study
was to investigate the individual and joint prognostic value of NLR and
PLR in acute ischemic stroke (AIS).
