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Association between lymphocyte-to-monocyte ratio and stroke-associated pneumonia: a retrospective cohort study
Xiaoqiang Li1, Xiangmao Zhou2, Hui Wang1
1Department of Neurology, Xiaolan People's Hospital of Zhongshan (The Fifth People's Hospital of Zhongshan), Zhongshan, Guangdong, China.
Background:
Stroke-associated pneumonia (SAP) is a common complication of acute ischemic stroke (AIS) and is associated with increased mortality and prolonged hospital stays. The lymphocyte-to-monocyte ratio (LMR) is a novel inflammatory marker that has been shown to be associated with various diseases. However, the relationship between the LMR and SAP in patients with AIS remains unclear.
Methods:
A retrospective cohort study was conducted on 1,063 patients with AIS admitted to our hospital within 72 hours of symptom onset. Patients were divided into two groups: the SAP group (n = 99) and the non-SAP group (n = 964). The LMR was measured within 24 hours of admission, and the primary outcome was the incidence of SAP. We used univariate and multivariate logistic regression analyses to assess the relationship between the LMR and SAP. Additionally, curve-fitting techniques and subgroup analyses were conducted.
Result:
The incidence of SAP was 9.31%. We found that the LMR was significantly lower in the SAP group than in the non-SAP group (2.46 ± 1.44 vs. 3.86 ± 1.48, P < 0.001). A nonlinear relationship was observed between the LMR and the incidence of SAP. Subgroup analysis revealed that an elevated LMR was associated with a reduced incidence of SAP in individuals with an LMR below 4. Multivariate logistic regression analysis demonstrated that LMR was an independent predictor of SAP (OR = 0.37, 95% CI [0.27-0.53]).
Conclusion:
Our study suggests that the LMR is an independent predictor of SAP in patients with AIS, particularly when the LMR is less than 4. The LMR may serve as a promising biomarker for the early identification of patients with AIS at a high risk of SAP.
Insights
The lymphocyte-to-monocyte ratio (LMR) can predict stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients. A lower LMR indicates a higher risk of developing SAP after stroke.
Area of Science:
- Neurology
- Immunology
- Inflammation
Background:
- Stroke-associated pneumonia (SAP) is a frequent and serious complication following acute ischemic stroke (AIS).
- SAP significantly increases mortality rates and prolongs hospital stays in AIS patients.
- The lymphocyte-to-monocyte ratio (LMR) is an emerging inflammatory marker, but its role in SAP following AIS is not well-defined.
Purpose of the Study:
- To investigate the association between the lymphocyte-to-monocyte ratio (LMR) and the incidence of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).
- To determine if LMR can serve as an independent predictor for SAP in AIS patients.
Main Methods:
- A retrospective cohort study included 1,063 patients with AIS.
- Patients were categorized into SAP (n=99) and non-SAP (n=964) groups.
- Lymphocyte-to-monocyte ratio (LMR) was measured within 24 hours of admission; logistic regression analyses were used to assess the relationship with SAP.
Main Results:
- The incidence of SAP was 9.31%.
- Patients with SAP had significantly lower LMR compared to the non-SAP group (2.46 ± 1.44 vs. 3.86 ± 1.48, P < 0.001).
- A lower LMR (<4) was independently associated with a reduced risk of SAP (OR = 0.37, 95% CI [0.27-0.53]).
Conclusions:
- The lymphocyte-to-monocyte ratio (LMR) is an independent predictor of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).
- An LMR below 4 is particularly indicative of increased SAP risk.
- LMR shows potential as a biomarker for early risk stratification of SAP in AIS patients.
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