Lingling Zhao,1,* Shuyu Zhou,1,* Qiliang Dai,2 Junrong Li1 

1Department of Neurology, The Affiliated Jiangning Hospital of Nanjing Medical University, Jiangning Clinical Medical School, Kangda College of Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Junrong Li, Department of Neurology, The Affiliated Jiangning Hospital of Nanjing Medical University,Jiangning Clinical Medical School, Kangda College of Nanjing Medical University, 169  Hushan Road, Nanjing, People’s Republic of China, 211100, Email ljry612@163.com

Background: Early neurologic deterioration (END) in acute ischemic stroke could result in significant worsening of clinical prognosis. Neutrophil lymphocyte ratio (NLR) is related to stroke severity and might be a predictor of short-term mortality in acute ischemic stroke. This study investigated the relationship between NLR and END in anterior circulation stroke patients.
Methods: Consecutive patients with first-ever acute ischemic stroke admitted to hospital within 24-hour of symptom onset were analyzed. NLR was calculated according to the Laboratory parameters obtained during the first 24 hours after admission. The rate of the END was recorded during the first 72-hours of admission. Multivariate logistic regression was applied to investigate the relationship between NLR and END.
Results: We included 228 consecutive patients within 24-hours of symptom onset for the final analysis. In total, 64 (28.1%) experienced END during the first 72 hours after admission. Patients with END were more likely to have higher NLR (median NLR 3.8 vs 2.4; p< 0.001) compared with those without END. Multivariate logistic regression revealed that NLR> 2.65 (OR, 4.019; 95% CI, 1.937– 8.337; p< 0.001) was an independent predictor of END. Also, patients in high NLR subgroup (NLR> 2.65) at admission were more likely to have prolonged length of stays (median length of stays 12 vs 4; p< 0.001).
Conclusion: This study found NLR was an independent predictor of END in patients with anterior circulation stroke.

Keywords: neutrophil lymphocyte ratio, END, stroke