Abstract Details

Title Associations of Admission and Follow-up Neutrophil-lymphocyte Ratios with Clinical Outcomes in Patients with Ischemic Stroke Undergoing Endovascular Therapy

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-004

Objective To investigate associations between neutrophil-lymphocyte ratios (NLRs) and clinical outcomes in ischemic stroke after endovascular therapy (ET).

Background NLRs can be used to assess inflammatory status, with higher NLRs indicating inflammation and physiologic stress. NLRs after ischemic stroke have been shown to predict both short- and long-term outcomes.

Design/Methods This was a retrospective study of adult patients admitted to a high-volume stroke center in 1/1/2018-12/31/2020 for ischemic stroke who underwent ET. The primary outcomes were successful reperfusion (TICI score ≥2B), favorable discharge NIH Stroke Scale/Score (NIHSS≤4), favorable discharge and 3-month modified Rankin Scale (mRS≤2) scores, and symptomatic ICH (sICH). The primary predictor was neutrophil-lymphocyte ratio (NLR), measured at admission and throughout the hospital stay, as well as change in NLR between admission and post-ET.

Results The study included 404 patients, with a median admission NIHSS of 14 and median discharge NIHSS of 2. Almost all patients (93%) achieved successful reperfusion, and 16 (4%) developed sICH. The median discharge mRS was 3, and the median 3-month mRS was 2. The median admission NLR was 5.0 (range 0.7-83.0), and the median NLR change (admission to first measure post-ET) was 0.0 (range -13.8 to 12.3); NLR increased between admission and post-ET in 45% of patients. Each 1-unit increase in admission NLR was associated with an 8% decreased odds of successful perfusion, 10% decreased odds of favorable discharge mRS, and 12% decreased odds of favorable 3-month mRS. Each 1-unit increase in NLR on days 1, 3, and >5 post-ET was associated with a 15-16% increased odds of sICH.

Conclusions Admission and select follow-up NLRs were predictive of successful reperfusion, risk of sICH, and condition at discharge and at 3-months post-discharge in this patient population. These results show that NLRs, a readily available biomarker, can identify individuals at risk for poor outcomes after ET.

Authors/Disclosures
Yasaman Pirahanchi, MD (Brigham and Women's Hospital) PRESENTER	Dr. Pirahanchi has nothing to disclose.
Russell E. Bartt, MD, FAAN (Blue Sky Neurosciences)	Dr. Bartt has nothing to disclose.
	No disclosure on file
	No disclosure on file
David Bar-Or	David Bar-Or has received intellectual property interests from a discovery or technology relating to health care.

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