The Effect of Neutrophil to Lymphocyte and Neutrophil to Platelet Ratios on Prognosis in Stroke Patients

Background: The aim of this study is to determine the correlation of neuroinflammatory response biomarkers neutrophil to lymphocyte ratio (NLR), neutrophil to platelet ratio (NPR) with risk factors, etiology, and prognosis in stroke patients. 
Methods: Cases diagnosed with ischemic stroke were recruited in this study. Demographic data, comorbidities, laboratory findings, carotid doppler ultrasonography, NIHSS (National Institutes of Health Stroke Scale) and MRS (modified rankin scale) scores of the cases were documented. Afterwards, the cases were divided into 3 groups (posterior circulation infarct, anterior circulation infarct, and lacunar infarct). 
Results: A total of 133 patients, 65 female and 68 males, aged between 24 and 94 were included in this study. At the end of hospitalization, NLR (p=0.001) and NPR (p=0.007) were significantly found high in patients with unfavorable functional outcome (MRS≥3) and those who died compared to NLR (p=0.001) and NPR (p=0.008) in the favorable functional outcome group. The NLR cut-off value for unfavorable functional outcome (95% confidence interval lower limit of area-under-curve of ROC≥0.7) was found to be 4.0. 
Conclusion: High NLR and NPR values measured at first admission in patients with acute ischemic stroke are highly associated with unfavorable functional outcome and mortality, and NLR and NPR are important prognostic biomarkers in patients with acute ischemic stroke.