Prognostic value of neutrophil /lymphocyte ratio in acute ischemic stroke patients either received reperfusion therapy or not

Background: Very few studies have investigated the specific relationship between neutrophil-lymphocyte ratio (NLR) and the short-term prognosis of patients with acute ischemic stroke (AIS) and after receiving intravenous thrombolysis. Objectives: To discuss if there is a relationship between neutrophil-lymphocyte ratio and stroke severity in the emergency department and short-term prognosis whether the patient is treated by reperfusion therapy or not to use it as a rapid prognostic marker in acute ischemic stroke patients. Patients and Method: A prospective comparative interventional study was done on 56 patients with acute ischemic stroke at Menoufia University Hospitals. They were selected according to certain inclusion and exclusion criteria. NLR was assessed from the patients’ blood samples. Initial stroke severity was evaluated by Glasgow Coma Score (GCS), National Institutes of Health Stroke Scale (NIHSS) score and modified ranking scale (mRS), then was re-evaluated later after 24 hours of admission and after one month. Results: NLR among ischemic stroke patients with a bad prognosis was significantly higher than that of the patients who had a good prognosis. The optimal cutoff value of NLR for the prediction of unfavorable outcomes was 4.15 with a sensitivity of 100% and a specificity of 88.5%. Conclusion: Elevated NLR on the hospital admission is an easy and strong predictor of poor outcomes in AIS patients either receiving reperfusion therapy or not.