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Updated: Mar 14, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
NLR-FAR Index as a superior predictor of 30-day functional outcome after endovascular thrombectomy in acute ischemic
Xuchen Meng1, Weijie Zhong1, Dingzhong Tang2
1Neurosurgery Department, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective:
To determine whether the neutrophil-to-lymphocyte ratio-fibrinogen-to-albumin ratio (NLR-FAR) Index predicts long-term prognosis in acute ischemic stroke patients undergoing endovascular thrombectomy (EVT).
Introduction:
Systemic inflammatory imbalance contributes to ischemic brain injury, but the combined effect of NLR and FAR on EVT outcomes has remained unclear.
Methods:
We retrospectively analyzed patients treated with EVT. A composite inflammatory-coagulation index, designated as the NLR-FAR Index, was defined as the product of NLR and FAR. The primary endpoint was 30-day functional outcome defined by the modified Rankin Scale (mRS), with poor outcome as mRS ≥3. Logistic regression and restricted cubic spline analyses were used to assess associations.
Results:
Of 254 patients, 121 (47.6%) had poor outcomes. Higher NLR, FAR, and especially NLR-FAR Index were significantly associated with poor prognosis. The NLR-FAR Index showed the strongest predictive effect (adjusted OR = 1.910, 95% CI: 1.079-3.384). Restrictive cubic spline analysis shows that when the NLR-FAR index exceeds the threshold of 0.62, the risk of adverse outcomes at 30 days begins to significantly increase.
Conclusion:
The NLR-FAR Index independently predicts functional outcomes after EVT and outperforms NLR or FAR alone. This accessible biomarker may aid early risk stratification and individualized management in acute ischemic stroke.
