A Prospective Study of Role of Neutrophil-Lymphocyte Ratio in Short-Term Mortality in Patients with Stroke

Abstract

The Neutrophil-Lymphocyte Ratio (NLR) has emerged as a promising biomarker for predicting the onset and severity of stroke, one of the leading causes of morbidity and mortality worldwide. As an easily obtainable and cost-effective parameter derived from routine blood tests, NLR reflects the balance between systemic inflammation (neutrophils) and immune regulation (lymphocytes). This ratio has been shown to correlate with the severity of stroke, particularly ischemic stroke, where inflammation plays a critical role in pathogenesis. However, its specific role in predicting short-term mortality in stroke patients remains fully underexplored. This study aims to evaluate the utility of NLR effectiveness as an early predictor of 30-day mortality in patients presenting with acute stroke, potentially aiding in better risk assessment and clinical decision-making.

MATERIALS AND METHODS: This prospective cohort study was conducted at a tertiary care hospital, enrolling patients aged 18 years and older who were admitted with a diagnosis of acute ischemic or transient ischemic stroke. Exclusion criteria included patients with pre-existing inflammatory diseases, recent infections, or those on immunosuppressive therapy.

RESULTS: Eighty stroke patients were monitored throughout their hospital stay in this prospective cohort study. NLR was calculated soon after admission. Elevated NLR on admission was significantly associated with increased 30-day mortality. The findings indicate that NLR is an independent predictor of short-term mortality in stroke patients. This suggests that systemic inflammation, as reflected by NLR, plays a significant role in the early outcomes of stroke. Given the ease of obtaining NLR from routine blood tests, it could be readily incorporated into clinical practice for early risk stratification.

CONCLUSION: The neutrophil-lymphocyte ratio is a valuable predictor of short-term mortality in patients with acute stroke. Elevated NLR at admission is associated with a higher risk of death within 30 days, underscoring its potential as an early, accessible biomarker for guiding clinical management. Further studies are recommended to validate these findings in larger, more diverse populations and to explore the underlying mechanisms linking NLR to stroke prognosis.