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Published on: December 28, 2014
Association Between Neutrophil to Lymphocyte Ratio and Malignant Brain Edema in Patients With Large Hemispheric
Xueling Bai1, Changyi Wang1, Lu Wang1
1Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction:
Malignant brain edema (MBE) is a life-threatening complication for patients with large hemispheric infarction (LHI). Stroke-related inflammatory responses may cause secondary brain injury and lead to brain edema. The neutrophil to lymphocyte ratio (NLR) is a well-known systemic inflammatory biomarker. The aim of this study was to evaluate if NLR is associated with MBE in patients with LHI.
Methods:
A retrospective analysis was performed of LHI patients within 24 h from stroke onset admitted to the Department of Neurology, West China Hospital from January 1, 2017 to December 31, 2018. Blood samples were collected upon admission. MBE was diagnosed by any neurological deterioration accompanied by brain edema in follow-up images. Patients were categorized according to NLR tertiles. Univariate analyses were performed to identify potential confounding variables and a multivariate logistic regression analysis was conducted to determine the correlation between NLR and MBE.
Results:
A total of 257 patients with a mean age of 68.6 ± 14.0 years were identified. Among them, 83 (32.3%) patients developed MBE with a median time of one day (interquartile range [IQR] 0-2 days) from hospital admission. An elevated NLR was related to an increased risk of MBE when the lowest and highest tertiles were compared (odds ratio 2.27, 95% confidence interval 1.11-4.62, p = 0.024). The risk of MBE increased with the increase of NLR in a dosedependent manner (p for trend = 0.029). No interaction between potential modifiers and NLR on MBE was observed.
Conclusions:
Higher NLR was associated with an increased risk of MBE in patients with LHI.
Insights
Higher neutrophil-to-lymphocyte ratio (NLR) indicates increased risk of malignant brain edema (MBE) in large hemispheric infarction (LHI) patients. This finding highlights NLR as a potential biomarker for predicting severe stroke complications.
Area of Science:
- Neurology
- Inflammation Research
- Biomarker Discovery
Background:
- Malignant brain edema (MBE) is a severe complication of large hemispheric infarction (LHI).
- Stroke-induced inflammation contributes to secondary brain injury and edema.
- Neutrophil-to-lymphocyte ratio (NLR) is a recognized marker of systemic inflammation.
Purpose of the Study:
- To investigate the association between NLR and the development of MBE in LHI patients.
- To determine if NLR can serve as a predictive biomarker for MBE in stroke.
Main Methods:
- Retrospective analysis of 257 LHI patients admitted within 24 hours of stroke onset.
- Blood samples analyzed for NLR upon admission.
- MBE diagnosis based on neurological deterioration and follow-up imaging.
- Statistical analysis including univariate and multivariate logistic regression.
Main Results:
- 83 (32.3%) patients developed MBE.
- Elevated NLR was significantly associated with increased MBE risk (OR 2.27, p=0.024).
- A dose-dependent relationship observed between NLR levels and MBE risk (p for trend=0.029).
Conclusions:
- Higher NLR is linked to a greater risk of MBE in LHI patients.
- NLR may serve as a valuable prognostic biomarker for predicting MBE.
- Further research could explore therapeutic strategies targeting inflammation in LHI.
