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Objective: The aim of this study is to investigate whether Neutrophil / lymphocyte (NLR), Lymphocyte / MPV (mean platelet volume) (LMR) and thrombocyte / MPV (PMR) ratios obtained from the complete blood count, can be used as an effective marker in acute stroke for determining the prognosis and subtype of stroke.
Material and methods: Patients admitted to the emergency department with acute stroke symptoms between January 1, 2020 and December 31, 2020 were evaluated retrospectively. The patients were divided into two groups as hemorrhagic or ischemic cerebrovascular disease (CVD) according to the radiological findings. NLR, LMR and PMR ratios were calculated. The last diagnosis and hospitalization information were recorded and their 28-day mortality status was evaluated.
Results: A total of 764 patients were included in the study. The median age of the patients included in the study was 68 (IQR 25-75: 59-78) and 404 (52.9%) of the patients were male. In the analysis performed; it was observed that the LMR, NLR and PMR levels were significantly different in those who developed mortality on the 28th day (p = 0.009), (p = 0.002), (p = 0.026). In addition, only the NLR level was found to be significantly different in the ischemic group (p <0.001).
Conclusion: We think that in cases with stroke, NLR, LMR and PMR levels can be used in predicting the prognosis of this disease. Also, NLR is significantly higher in ischemic stroke, and also significant in terms of showing that CVD type is hemorrhagic or ischemic.
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2. Feigin VL. Stroke epidemiology in the developing world. Lancet (London, England). 2005;365(9478):2160-1.
3. Cai W, Liu S, Hu M, Huang F, Zhu Q, Qiu W, et al. Functional Dynamics of Neutrophils After Ischemic Stroke. Translational stroke research. 2020;11(1):108-21.
4. Dénes A, Ferenczi S, Kovács KJ. Systemic inflammatory challenges compromise survival after experimental stroke via augmenting brain inflammation, blood- brain barrier damage and brain oedema independently of infarct size. Journal of neuroinflammation. 2011;8:164.
5. de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Critical care (London, England). 2010;14(5):R192.
6. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2014;23(7):1204-12.
7. Kilic E, Rezvani A, Toprak A, Erman H, Ayhan S, Poyraz E, et al. Evaluation of neutrophil to lymphocyte and platelet to lymphocyte ratios in rheumatoid arthritis. Dicle Med J. 2016;43(2):241-7.
8. O'Connell GC, Chang JHC. Analysis of Early Stroke-induced Changes in Circulating Leukocyte Counts using Transcriptomic Deconvolution. Translational neuroscience. 2018;9:161-6.
9. Tokgoz S, Keskin S, Kayrak M, Seyithanoglu A, Ogmegul A. Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume? Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2014;23(8):2163-8.
10. Farah R, Samra N. Mean platelets volume and neutrophil to lymphocyte ratio as predictors of stroke. J Clin Lab Anal. 2018;32(1).
11. Boursin P, Paternotte S, Dercy B, Sabben C, Maïer B. [Semantics, epidemiology and semiology of stroke]. Soins; la revue de reference infirmiere. 2018;63(828):24-7.
12. Newbury J, Kleinig T, Leyden J, Arima H, Castle S, Cranefield J, et al. Stroke Epidemiology in an Australian Rural Cohort (SEARCH). International journal of stroke : official journal of the International Stroke Society. 2017;12(2):161-8.
13. Chen CY, Weng WC, Wu CL, Huang WY. Association between gender and stoke recurrence in ischemic stroke patients with high-grade carotid artery stenosis. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2019;67:62-7.
14. Kuklina EV, Tong X, George MG, Bansil P. Epidemiology and prevention of stroke: a worldwide perspective. Expert review of neurotherapeutics. 2012;12(2):199-208.
15. Domaç F, Ülker M, KARACI R, Demir M. The Relation Between Neutrophil-Lymphocyte Ratio and Etiologic Subtypes in Acute Ischaemic Stroke. The Medical Journal Of Haydarpaşa Numune Training and Research Hospital. 2019;61(1):0-.
16. Tanındı A, Erkan AF, Ekici B, Alhan A, Töre HF. Neutrophil to lymphocyte ratio is associated with more extensive, severe and complex coronary artery disease and impaired myocardial perfusion. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2014;42(2):125-30.
17. AYTAÇ E, AKPINAR ÇK, GÜRKAŞ E. Neutrophil to Lymphocyte Ratio: A Simple and Readily Available Independent Marker of Mortality in Acute Ischemic Stroke. Firat Tip Dergisi. 2017;22(4).
18. Guo G, Zeng Y, Chen Q, Zhan X, Long H, Peng F, et al. High Neutrophil/Lymphocyte Ratio as an Independent Risk Factor for the First Occurrence of Stroke in Peritoneal Dialysis Patients. Iranian journal of kidney diseases. 2020;14(4):282-9.
19. Kakhki RD, Dehghanei M, ArefNezhad R, Motedayyen H. The Predicting Role of Neutrophil- Lymphocyte Ratio in Patients with Acute Ischemic and Hemorrhagic Stroke. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2020;29(11):105233.
20. Tao C, Hu X, Wang J, Ma J, Li H, You C. Admission neutrophil count and neutrophil to lymphocyte ratio predict 90-day outcome in intracerebral hemorrhage. Biomarkers in medicine. 2017;11(1):33-42.
21. Tokgoz S, Kayrak M, Akpinar Z, Seyithanoğlu A, Güney F, Yürüten B. Neutrophil lymphocyte ratio as a predictor of stroke. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2013;22(7):1169-74.
22. Osadnik T, Wasilewski J, Lekston A, Strzelczyk J, Kurek A, Gonera M, et al. The platelet-to-lymphocyte ratio as a predictor of all-cause mortality in patients with coronary artery disease undergoing elective percutaneous coronary intervention and stent implantation. Journal of the Saudi Heart Association. 2015;27(3):144-51.
23. Şengeze N, Giray S. The Relationship Between Mean Platelet Volume, Platelet Count, Platelet Lymphocyte Ratio, and Recanalization Success in First-pass Thrombectomy of Middle Cerebral Artery Occlusions. Turk J Neurol. 2020;26(2):133-7.