Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score
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Publication Date: | 2022 |
Other Authors: | , , |
Format: | Article |
Language: | eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020 |
Summary: | Abstract Introduction: To assess the association of neutrophil-to-lymphocyte ratio (NLR) with post-stroke pneumonia (PSP) incidence, stroke subtype, severity, and prognosis. Material and Methods: Prospective observational study over a 42-month period in a Stroke Unit of a tertiary University Hospital. All patients with acute ischaemic stroke (AIS) were sequentially included. NLR was obtained at admission. Pa-tient characteristics such as stroke subtype, severity and PSP diagnosis were ascertained. Score A2DS2 was used as clinical predictor of PSP. Results: 521 patients with AIS were identified. The mean age was 76.17 ± 10.16 years years, 46.9% were men. Association was found between NLR and type and severity of stroke (p < 0.01), persisting in stratified analysis after excluding concomitant infection. Patients with higher ratio presented severer neurological deficits at admission, higher mortality, and dependency on discharge (p < 0.01). A logistic regression was performed to ascertain the predictive capacity of NLR (≥3) and A2DS2 (≥6) on the likelihood of developing PSP (p < 0.005). The model explained 17.1% (Nagelkerke R2) of the variance in pneumonia diagnoses, correctly classifying 77.0% of patients with 96.3% specificity. Patients with A2DS2 ≥6 were likelier to develop pneumonia (OR 8.36, p < 0.01). Moreover, patients with NLR ≥3 had higher odds of developing pneumonia (OR 2.35, p < 0.01). Conclusion: NLR appears to be related to severity in AIS, possibly as surrogate of neuroimmune mediation. Advances in the understanding of the immunobiological effects of ischemia in the brain may lead to future therapeutic developments. Presently, as a relatively inexpensive biomarker, there may be a potential role for NLR in improving PSP prediction scores. |
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Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia ScoreLymphocytesNeutrophilsPneumoniaStroke/complications.Abstract Introduction: To assess the association of neutrophil-to-lymphocyte ratio (NLR) with post-stroke pneumonia (PSP) incidence, stroke subtype, severity, and prognosis. Material and Methods: Prospective observational study over a 42-month period in a Stroke Unit of a tertiary University Hospital. All patients with acute ischaemic stroke (AIS) were sequentially included. NLR was obtained at admission. Pa-tient characteristics such as stroke subtype, severity and PSP diagnosis were ascertained. Score A2DS2 was used as clinical predictor of PSP. Results: 521 patients with AIS were identified. The mean age was 76.17 ± 10.16 years years, 46.9% were men. Association was found between NLR and type and severity of stroke (p < 0.01), persisting in stratified analysis after excluding concomitant infection. Patients with higher ratio presented severer neurological deficits at admission, higher mortality, and dependency on discharge (p < 0.01). A logistic regression was performed to ascertain the predictive capacity of NLR (≥3) and A2DS2 (≥6) on the likelihood of developing PSP (p < 0.005). The model explained 17.1% (Nagelkerke R2) of the variance in pneumonia diagnoses, correctly classifying 77.0% of patients with 96.3% specificity. Patients with A2DS2 ≥6 were likelier to develop pneumonia (OR 8.36, p < 0.01). Moreover, patients with NLR ≥3 had higher odds of developing pneumonia (OR 2.35, p < 0.01). Conclusion: NLR appears to be related to severity in AIS, possibly as surrogate of neuroimmune mediation. Advances in the understanding of the immunobiological effects of ischemia in the brain may lead to future therapeutic developments. Presently, as a relatively inexpensive biomarker, there may be a potential role for NLR in improving PSP prediction scores.Sociedade Portuguesa de Medicina Interna2022-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020Medicina Interna v.29 n.1 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020Pedro,DiogoNarciso,MarcoAlves,MarianaFonseca,Teresa Passosinfo:eu-repo/semantics/openAccess2024-02-06T17:08:35Zoai:scielo:S0872-671X2022000100020Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:20:55.903970Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
title |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
spellingShingle |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score Pedro,Diogo Lymphocytes Neutrophils Pneumonia Stroke/complications. |
title_short |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
title_full |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
title_fullStr |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
title_full_unstemmed |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
title_sort |
Neutrophil-to-Lymphocyte Ratio: The Role of Adding a Biomarker to a Predictive Post-Stroke Pneumonia Score |
author |
Pedro,Diogo |
author_facet |
Pedro,Diogo Narciso,Marco Alves,Mariana Fonseca,Teresa Passos |
author_role |
author |
author2 |
Narciso,Marco Alves,Mariana Fonseca,Teresa Passos |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Pedro,Diogo Narciso,Marco Alves,Mariana Fonseca,Teresa Passos |
dc.subject.por.fl_str_mv |
Lymphocytes Neutrophils Pneumonia Stroke/complications. |
topic |
Lymphocytes Neutrophils Pneumonia Stroke/complications. |
description |
Abstract Introduction: To assess the association of neutrophil-to-lymphocyte ratio (NLR) with post-stroke pneumonia (PSP) incidence, stroke subtype, severity, and prognosis. Material and Methods: Prospective observational study over a 42-month period in a Stroke Unit of a tertiary University Hospital. All patients with acute ischaemic stroke (AIS) were sequentially included. NLR was obtained at admission. Pa-tient characteristics such as stroke subtype, severity and PSP diagnosis were ascertained. Score A2DS2 was used as clinical predictor of PSP. Results: 521 patients with AIS were identified. The mean age was 76.17 ± 10.16 years years, 46.9% were men. Association was found between NLR and type and severity of stroke (p < 0.01), persisting in stratified analysis after excluding concomitant infection. Patients with higher ratio presented severer neurological deficits at admission, higher mortality, and dependency on discharge (p < 0.01). A logistic regression was performed to ascertain the predictive capacity of NLR (≥3) and A2DS2 (≥6) on the likelihood of developing PSP (p < 0.005). The model explained 17.1% (Nagelkerke R2) of the variance in pneumonia diagnoses, correctly classifying 77.0% of patients with 96.3% specificity. Patients with A2DS2 ≥6 were likelier to develop pneumonia (OR 8.36, p < 0.01). Moreover, patients with NLR ≥3 had higher odds of developing pneumonia (OR 2.35, p < 0.01). Conclusion: NLR appears to be related to severity in AIS, possibly as surrogate of neuroimmune mediation. Advances in the understanding of the immunobiological effects of ischemia in the brain may lead to future therapeutic developments. Presently, as a relatively inexpensive biomarker, there may be a potential role for NLR in improving PSP prediction scores. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-03-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020 |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000100020 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Medicina Interna v.29 n.1 2022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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