Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of Adverse Short-Term Functional Outcomes After...

Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) are primary treatments for acute ischemic stroke (AIS), but their efficacy is limited. This study aims to evaluate the short-term predictive value of the neutrophil-to-lymphocyte ratio (NLR) in AIS patients undergoing reperfusion therapies.

AIS patients who underwent IVT and/or EVT at Chengdu Second People's Hospital were continuously enrolled from January 2020 to September 2024. NLR was calculated from blood samples taken before treatment. Primary outcomes were functional status at discharge (assessed using the modified Rankin Scale [mRS]), while secondary outcomes included in-hospital mortality and any intracranial hemorrhage (ICH). Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve analysis.

Among 817 patients, 327 (40.0%) exhibited poor functional outcomes at discharge. NLR positively correlated with the National Institutes of Health Stroke Scale score (ρ = 0.298, p < 0.001). Univariate analysis showed a significant association between NLR and poor functional outcomes at discharge, higher in-hospital mortality, and increased ICH incidence. After adjusting for confounders, NLR remained an independent predictor of functional outcomes (odds ratio 1.092; 95% confidence interval [CI] 1.006-1.185; p = 0.036). ROC analysis showed that NLR could predict functional outcomes with a cutoff value of 3.66 and an area under the curve of 0.679 (95% CI 0.641-0.717, p < 0.001).

NLR is an independent predictor of short-term functional outcomes and complications in AIS patients receiving reperfusion therapies, serving as a valuable tool for early prognosis and clinical decision-making.