Predictive value of admission neutrophil/lymphocyte ratio in symptomatic intracranial hemorrhage after stroke thrombolysis

• Published in: Neurological sciences Vol. 43; no. 1; pp. 435 - 440
• Main Authors: Ören, Oğuz, Haki, Cemile, Kaya, Halil, Yüksel, Melih
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2022; Springer Nature B.V
• Subjects: Adolescent; Adult; Blood pressure; Brain Ischemia - complications; Brain Ischemia - drug therapy; Cerebral Hemorrhage - drug therapy; Emergency medical care; Fibrinolytic Agents - adverse effects; Hemorrhage; Humans; Intracranial Hemorrhages - chemically induced; Intracranial Hemorrhages - drug therapy; Intravenous administration; Ischemia; Leukocytes (neutrophilic); Lymphocytes; Medicine; Medicine & Public Health; Morbidity; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Neutrophils; Original Article; Patients; Psychiatry; Retrospective Studies; Statistical analysis; Stroke; Stroke - complications; Stroke - drug therapy; Thrombolysis; Thrombolytic Therapy; Tissue Plasminogen Activator - therapeutic use; Treatment Outcome; Stroke; Neutrophil lymphocyte ratio; Thrombolytic therapy
• ISSN: 1590-1874; 1590-3478
• DOI: 10.1007/s10072-021-05326-8

Background
Stroke is one of the most common causes of morbidity and mortality. The need for additional objective parameters as well as the existing criteria continues for eligible patients. The objective of this study is to determine whether the baseline neutrophil/lymphocyte ratio (NLR) predicts symptomatic intracranial hemorrhage (SICH) due to intravenous thrombolytic therapy.
Material and methods
One hundred thirty-three consecutive patients aged 18 years and over who were admitted to the emergency department of a training and research hospital for acute ischemic stroke and underwent intravenous thrombolytic therapy were retrospectively analyzed. For the definition of SICH, European Cooperative Acute Stroke Study III (ECASS III) classification was accepted.
Results
When the groups with and without intracranial hemorrhage were compared, there was a significant difference in terms of the initial National Institutes of Health Stroke Scale (NIHSS) score (p < 0.006), glucose level (p < 0.018), and systolic blood pressure (SBP) (p < 0.050). The NLR value of the patients ranged from 0.47 to 13.74. In the group with SICH, NLR was found to be higher but not statistically significant. (p = 0.125).
Conclusion
For predicting SICH, NLR did not provide strong specificity and sensitivity. A precise cut-off value could not be found to predict the hemorrhagic transformation.