ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neuroinflammation and Neuropathy
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1611289
This article is part of the Research TopicStroke Research in the Elderly: Addressing Ageism and PrognosticationView all 10 articles
Association of neutrophil-percentage-to-albumin ratio (NPAR) with mortality in older stroke survivors
Provisionally accepted
- Lishui Central Hospital, Lishui, China
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The neutrophil-percentage-to-albumin ratio (NPAR) functions as an integrative marker representing inflammatory response and nutritional health. However, its association with mortality in elderly stroke survivors has not been explored.This cohort study analyzed data from 1026 elderly stroke survivors in the National Health and Nutrition Examination Survey (NHANES, 1999(NHANES, -2018)). The association of NPAR with mortality was analyzed using Cox proportional hazards regression, restricted cubic splines (RCS), Kaplan-Meier survival analysis, and time-dependent receiver operating characteristic (ROC) curves. Subgroup analyses and interaction tests were also performed.During the 6.65-year median follow-up, elevated NPAR showed independent associations with increased all-cause and cardiovascular mortality. Quartile-based analysis revealed 69% and 87% greater mortality hazards for the highest versus lowest NPAR groups, respectively. RCS analysis revealed a non-linear threshold effect at NPAR=14.5, beyond which the risk of all-cause mortality increased sharply. NPAR demonstrated stable predictive accuracy, with time-dependent AUC ranging from 0.664-0.607 for allcause mortality and 0.652-0.609 for cardiovascular mortality over 3-10 years. Subgroup analyses confirmed consistency across different sex, BMI, lifestyle habits, and comorbidity categories.This study underscores a strong positive correlation between NPAR and prognosis in older adult stroke survivors in the United States, indicating its potential as a novel biomarker for prognostic assessment.
Keywords: NPAR, Elderly, stroke survivors, Mortality, NHANES
Received: 14 Apr 2025; Accepted: 12 May 2025.
Copyright: © 2025 Huang, Zhang, Ding, Yu and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingshen Lin, Lishui Central Hospital, Lishui, China
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