Evaluation of the effects of inflammation markers on mortality in patients with A diagnosis of acute stroke in the intensive care unit

Introduction and Aim: The stroke is a major public health problem due to its high prevalence worldwide, causing mortality and morbidity. The inflammatory response that begins after acute stroke is considered to be an important pathological process involving secondary injury after ischemic and hemorrhagic brain injury. In the inflammatory process; platelets also play a role in inflammation and are responsible for chemokine cytokine production. The chemokines and cytokines released from injured tissues promote the infiltration of peripheral circulating leukocytes to the injured sites. Neutrophils among the peripheral circulating leukocytes are considered an important mediator in brain damage. So far, many studies demonstrated that infiltration of neutrophils into the injured brain area increases brain damage. Although the role of lymphocytes in brain injury is controversial more experimental evidences demonstrated that some specific subtypes of lymphocytes play key roles in the inflammatory response to brain injury. It is important to determine the prognosis of patients hospitalized in the intensive care unit. Patients with acute stroke have an important place among patients in need of intensive care. In this study, we tried to determine the effect of neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) on prognosis in patients with acute stroke Materials and Methods: 400 acute stroke patients who were hospitalized in Dicle University Hospital Internal Medicine Intensive Care Unit and Neurology Intensive Care Unit between January 2012 and November 2019 were included in this study. Acute stroke defined as ischemic and hemorrhagic stroke. The study was designed retrospectively. The demographic characteristics, etiologies, comorbid diseases and laboratory findings of patients were taken from patient files. Length of stay and clinical results in the intensive care unit were recorded. Neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were measured. Patients were classified as deceased (group 1) and survivors (group2). Two groups were compared with the parameters studied. Results: Patients were classified as deceased (group1) (n:227) and survivors (group2) (n:173). Age, length of stay, systolic blood pressure, leukocyte count, neutrophil count, platelet count, blood glucose, creatine, CRP, neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR) were found to be statistically significant in the deceased group compared to the surviving group. And these parameters were higher in group 1 than group 2(p<0,05). Albumin was lower in the deceased group(p<0,05). There was a positive correlation between the mortality of the patients and the high NLR, PLR, CRP. Mortality was higher and overall survival was worse in patient groups with NLR≥5, PLR≥300, CRP> 1. Conclusion: Mortality of patients with high NLR, PLR and CRP values was found to be higher in patients who were followed up and treated for acute stroke in the intensive care unit. Overall survival of these patients was worse.