AUTHOR=Wu Bing , Liu Fang , Sun Guiyan , Wang Shuang 

TITLE=Prognostic role of dynamic neutrophil-to-lymphocyte ratio in acute ischemic stroke after reperfusion therapy: A meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1118563

DOI=10.3389/fneur.2023.1118563

ISSN=1664-2295

ABSTRACT=Background: The prognostic role of the neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, in acute ischemic stroke (AIS) after reperfusion therapy remains controversial. Therefore, this meta-analysis sought to assess the correlation between the dynamic NLR and clinical outcomes of patients with AIS after reperfusion therapy.
Methods: PubMed, Web of Science, and Embase databases were searched to identify relevant literature from inception to October 27, 2022. The clinical outcomes of interest included poor functional outcome (PFO) at 3 months, symptomatic intracerebral hemorrhage (sICH), and 3-month mortality. NLR on admission (pre-treatment) and post-treatment were collected. PFO was defined as modified Rankin scale (mRS) >2.
Results: A total of 17232 patients in 52 studies were included in the meta-analysis. Admission NLR was higher in PFO (SMD = 0.46, P < 0.001), sICH (SMD = 0.57, P < 0.001), and mortality (SMD = 0.60, P < 0.001). Elevated admission NLR was associated with increased risks of PFO (OR = 1.13, P < 0.001), sICH (OR = 1.11, P < 0.001), and mortality (OR = 1.13, P < 0.001). Post-treatment NLR was significantly higher in PFO (SMD = 0.80, P < 0.001), sICH (SMD = 1.54, P < 0.001), and mortality (SMD = 1.00, P = 0.004). Elevated post-treatment NLR was significantly associated with increased risks of PFO (OR = 1.25, P < 0.001), sICH (OR = 1.14, P < 0.001), and mortality (OR = 1.28, P = 0.002).
Conclusions: Admission and post-treatment NLR can be used as cost-effective and easily available biomarkers to predict PFO, sICH, and mortality in patients with AIS treated with reperfusion therapy. The post-treatment NLR provides better predictive power than admission.