AUTHOR=Zhao Jun , Feng Jinli , Ma Qian , Li Chunlin , Qiu Feng 

TITLE=Prognostic value of inflammation biomarkers for 30-day mortality in critically ill patients with stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1110347

DOI=10.3389/fneur.2023.1110347

ISSN=1664-2295

ABSTRACT=Objective: To explore the values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), neutrophil to albumin ratio (NAR), prognostic nutritional index (PNI), systemic immune inflammatory index (SII) and red cell distribution width to albumin ratio (RA) for evaluating the risk of 30-day mortality of ischemic stroke or hemorrhagic stroke patients. 
Methods: In the cohort study, the data of 1,601 patients diagnosed with stroke were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Among them, 908 were hemorrhagic stroke patients and 693 were ischemic stroke patients. Demographic and clinical variables of patients were collected. Univariate and multivariable Cox regression were performed to evaluate the predictive values of NLR, PLR, SII, NAR, RA and PNI on 30-day mortality in hemorrhagic stroke or ischemic stroke patients. The receiver operator characteristic (ROC) curves were plotted to assess the diagnostic values of NLR, NAR and RA for 30-day mortality in hemorrhagic stroke.
Results: At the end of follow-up, 226 hemorrhagic stroke patients and 216 ischemic stroke patients died. Elevated NLR level was associated with increased risk of 30-day mortality in hemorrhagic stroke [hazard ratio (HR)=1.17, 95% confidence interval (CI): 1.06-1.29]. Increased NAR level was associated with elevated risk of 30-day mortality in hemorrhagic stroke (HR=1.16, 95%CI: 1.02-1.30). High RA level was linked with increased risk of 30-day mortality (HR=1.44, 95%CI: 1.23-1.69). No significant correlation was observed in these inflammation biomarkers with the risk of 30-day mortality in ischemic stroke patients. The area under the curves (AUCs) of NLR, NAR and RA for evaluating the risk of 30-day mortality in hemorrhagic stroke were 0.552 (95%CI: 0.503-0.601), 0.644 (95%CI: 0.590-0.699) and 0.541 (95%CI: 0.490-0.592).
Conclusion: NLR, NAR and RA were potential prognostic biomarkers for predicting 30-day mortality in hemorrhagic stroke patients, which might provide clinicians an easy and cheap way to quickly identify patients with high risk of mortality.