Evaluation of early neutrophil to lymphocyte ratio and some laboratory parameters with radiologic findings in acute stroke patients

Neutrophil to lymphocyte ratio (NLR) as well as platelet to lymphocyte ratio (PLR) was proposed to be a predictor for prognosis in some diseases. In the present study, the NLR and PLR values of the acute ischemic stroke cases were calculated and the clinical, laboratory and imaging findings were evalueted according to the NLR and PLR values of the cases. Eighty ischemic stroke patients, who were admitted to the Gaziantep University Neurology Department inpatient clinic between December 2015 and September 2016, were enrolled. Sociodemographic characteristics, NIHSS and mRS scores at the time of referral, NLR and PLR values in the acute phase, NLR and PLR values in the control blood, some biochemical and serological parameters, brain imaging features, Doppler ultrasound, echocardiography (ECHO), electrocardiography (ECG) findings, complications during in-patient follow up, and duration of hospitalization were investigated to find out if these parameters have a statistically important relationship or not. According to our results, the NLR and PLR values in the first and second blood samples were similar. NLR cut-off point in the whole group to assess the stroke severity was determined as 2,86 with high sensitivity and specificity (88.9% and 72.6%, respectively). The cut-off point was found to be 2.86 in the cases without infection which was similar with the whole group, with a higher sensitivity and specificity (100 % and 83 %, respectively). Mean age, NIHSS scores, CRP, sedimentation, leukocyte, platelet counts and duration of hospitalization in low NLR patients was found to be significantly lower than the cases with high NLR. More infections were detected in patients with high NLR during the in-patient follow up. A cut-off point for the TLR could not be obtained. TLR values were revealed a statistically significant positive relationship with NLR values; however similar associations could not be shown for other parameters that were searched. As a result, NLR in the acute phase of ischemic stroke may be used as a predictor of the severity of the stroke; duration of hospitalization and the risk of developing infections during in-patient follow up. Also NLR changes are seem likely to be effected from the ischemic stroke itself independently from the presence of infectious diseases. Key words: Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Ischemic stroke, Complication, NIHSS