Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Brain and Behavior - Tập 9 Số 9 - 2019
Ruirui Zhang1, Xiaodong Wu1, Wenjie Hu1, Li Zhao1, Shoucai Zhao1, Ji Zhang1, Zhaohu Chu1, Yang Xu1,2,3
1Department of Neurology Wannan Medical College First Affiliated Hospital Yijishan Hospital Wuhu China
2Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institutes, Wannan Medical College, Wuhu, China
3Non-Coding RNA Research Center of Wannan Medical College, Wuhu, China

Tóm tắt

AbstractIntroduction

The neutrophil‐to‐lymphocyte ratio (NLR) has been shown to be a marker associated with inflammation and is independently associated with the adverse clinical outcomes of symptomatic intracranial hemorrhage, cancer, and cardiovascular disease. Hemorrhagic transformation (HT) is a serious complication of ischemic cerebral infarction and can be intensified by therapeutic interventions for acute ischemic stroke (AIS). The purpose of our research was to explore the predictive effect of NLR for HT in patients with AIS and to determine the best predictive value.

Methods

PubMed, Web of Science, EMBASE, MEDLINE, Cochrane, and Google Scholar were searched. The primary endpoint was HT, and subgroup analysis was performed. Review Manager software version 5.3 was used to statistically analyze the outcomes.

Results

A total of seven studies including 3,726 patients met the inclusion criteria. The pooled odds ratio (OR) value of the high NLR that predicted HT in AIS patients was 1.53 (95% CI, 1.21–1.92; p = .0003). In addition, 1.10 (95% CI, 1.05–1.15; p < .0001) was the pooled OR of the high NLR associated with increased 3‐month mortality in patients with AIS. In the subgroup analysis with an NLR cutoff value of 7.5–11, the correlation between NLR above the cutoff value and the rate of HT in patients with AIS was statistically significant (OR, 7.93; 95% CI, 2.25–27.95; p = .001).

Conclusion

A high NLR can predict HT and 3‐month mortality in patients with AIS. Regardless of the country of origin and the sampling time, an NLR with a cutoff value of 7.5–11 was independently associated with HT in AIS patients.

Từ khóa


Tài liệu tham khảo

10.1067/mhj.2001.115792

10.1586/erc.12.159

10.1136/neurintsurg-2013-010780

10.1159/000489401

10.1016/j.bj.2017.03.002

10.1016/j.jstrokecerebrovasdis.2018.08.028

Gokhan S., 2013, Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack, European Review for Medical and Pharmacological Sciences, 17, 653

10.1161/STR.0b013e3181fcb238

10.1161/STROKEAHA.118.021477

10.1186/s12974-016-0680-x

10.1161/STROKEAHA.116.016368

10.1016/j.jneuroim.2018.04.015

Inanc Y., 2018, The effects of neutrophil to lymphocyte and platelet to lymphocyte ratios on prognosis in patients undergoing mechanical thrombectomy for acute ischemic stroke, Annali Italiani di Chirurgia, 89, 367

10.1038/jcbfm.2013.203

10.1016/j.atherosclerosis.2012.02.042

10.1161/01.STR.0000092527.33910.89

10.1007/s12975-018-0649-4

10.1111/j.1365-3083.2005.01683.x

10.1016/j.ijcard.2015.03.114

10.1212/WNL.0000000000002029

10.1111/ene.13741

10.1016/j.jstrokecerebrovasdis.2017.12.044

10.1016/S0002-9149(96)00878-8

10.1016/j.cca.2011.01.021

10.1186/s12974-018-1359-2

10.1007/s12640-017-9707-z

10.1161/STROKEAHA.107.500868

Song Q., 2018, Increased neutrophil‐to‐lymphocyte ratios are associated with greater risk of hemorrhagic transformation in patients with acute ischemic stroke, Current Neurovascular Research

10.1161/CIRCRESAHA.110.223883

10.1016/j.jstrokecerebrovasdis.2014.04.007

10.1161/STROKEAHA.115.010049

10.1016/j.jstrokecerebrovasdis.2016.11.010

10.18632/oncotarget.20120

10.1016/j.jns.2018.02.002

Zahorec R., 2001, Ratio of neutrophil to lymphocyte counts–rapid and simple parameter of systemic inflammation and stress in critically ill, Bratislavske Lekarske Listy, 102, 5

10.1097/MD.0000000000008624

Thông tin
Thông tin xuất bản

Brain and Behavior

Tập 9 Số 9

Thông tin tác giả