Combination of White Matter Hyperintensity and Neutrophil-to-Lymphocyte Ratio Predicts Short-Term Prognosis of Acute Ischemic Stroke Patients.

IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2024-12-14 eCollection Date: 2024-01-01 DOI:10.2147/IJGM.S486511

Qingyan Zhang, Danyue Ma, Hebin Du, Tiantian Wang, Wei Li

{"title":"Combination of White Matter Hyperintensity and Neutrophil-to-Lymphocyte Ratio Predicts Short-Term Prognosis of Acute Ischemic Stroke Patients.","authors":"Qingyan Zhang, Danyue Ma, Hebin Du, Tiantian Wang, Wei Li","doi":"10.2147/IJGM.S486511","DOIUrl":null,"url":null,"abstract":"Purpose: To assess the value of combination of white matter hyperintensity (WMH) and neutrophil-to-lymphocyte ratio (NLR) in predicting short-term prognosis of acute ischemic stroke (AIS) patients.Patients and methods: Three hundred and nine AIS patients were included in this prospective observational research. They were evaluated at 3-month after the onset of AIS using modified Rankin Scale (mRS) score. A mRS score of 0-2 was defined as a favourable outcome, while an mRS score of 3-6 was defined as an unfavourable outcome. Multivariate analysis was used to identify the independent associations of WMH and NLR with short-term prognosis of AIS patients, and receiver operating characteristic (ROC) curves were used to evaluate the predictive values of WMH, NLR and their combination for short-term prognosis of AIS patients, and Z test was used to compare the area under curve (AUC).Results: Among 309 AIS patients, 201 (65.0%) had a favorable 3-month outcome, while 108 (35.0%) had an unfavorable outcome. According to the results of multivariate analysis, WMH, NLR and on-admission NIHSS score were independently associated with unfavourable outcome of AIS after adjusting for diabetes mellitus, atrial fibrillation, TOAST subtype and LDL-cholesterol. ROC curves showed that the AUCs of WMH, NLR and their combination for predicting short-term prognosis of AIS patients were 0.760 [standard error (SE): 0.029, 95% confidence interval (CI): 0.703-0.817, P<0.001], 0.717 (SE: 0.030, 95% CI: 0.661-0.774, P<0.001) and 0.906 (SE: 0.019, 95% CI: 0.868-0.944, P<0.001), respectively. The AUC of combination prediction was significantly higher than those of individual predictions (0.906 vs 0.760, Z=4.211, P<0.001; 0.906 vs 0.717, Z=5.322, P<0.001).Conclusion: WMH and NLR were independently associated with short-term prognosis of AIS patients, and the combination of WMH and NLR could be applied in predicting short-term prognosis of AIS patients, having a high predictive value.","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"17 ","pages":"6199-6206"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653866/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S486511","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To assess the value of combination of white matter hyperintensity (WMH) and neutrophil-to-lymphocyte ratio (NLR) in predicting short-term prognosis of acute ischemic stroke (AIS) patients.

Patients and methods: Three hundred and nine AIS patients were included in this prospective observational research. They were evaluated at 3-month after the onset of AIS using modified Rankin Scale (mRS) score. A mRS score of 0-2 was defined as a favourable outcome, while an mRS score of 3-6 was defined as an unfavourable outcome. Multivariate analysis was used to identify the independent associations of WMH and NLR with short-term prognosis of AIS patients, and receiver operating characteristic (ROC) curves were used to evaluate the predictive values of WMH, NLR and their combination for short-term prognosis of AIS patients, and Z test was used to compare the area under curve (AUC).

Results: Among 309 AIS patients, 201 (65.0%) had a favorable 3-month outcome, while 108 (35.0%) had an unfavorable outcome. According to the results of multivariate analysis, WMH, NLR and on-admission NIHSS score were independently associated with unfavourable outcome of AIS after adjusting for diabetes mellitus, atrial fibrillation, TOAST subtype and LDL-cholesterol. ROC curves showed that the AUCs of WMH, NLR and their combination for predicting short-term prognosis of AIS patients were 0.760 [standard error (SE): 0.029, 95% confidence interval (CI): 0.703-0.817, P<0.001], 0.717 (SE: 0.030, 95% CI: 0.661-0.774, P<0.001) and 0.906 (SE: 0.019, 95% CI: 0.868-0.944, P<0.001), respectively. The AUC of combination prediction was significantly higher than those of individual predictions (0.906 vs 0.760, Z=4.211, P<0.001; 0.906 vs 0.717, Z=5.322, P<0.001).

Conclusion: WMH and NLR were independently associated with short-term prognosis of AIS patients, and the combination of WMH and NLR could be applied in predicting short-term prognosis of AIS patients, having a high predictive value.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.