The neutrophil-to-lymphocyte ratio is associated with functional outcome among single small subcortical infarction: Mediating effects of white matter hyperintensities
Yue Wu , Jin Hu , Yutie Zhao , Dongshen Ju , Shudong Cao , Jintao Guo , Weihua Song , Ran Mo , Shaoyuan Lei , Yifan Wu , Yingting Zuo , Shujuan Meng , Ziying Jiang , Gaoting Ma , Lianmei Zhong , Yansu Guo
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引用次数: 0
Abstract
Background
Increasing evidence indicated that neutrophil-to-lymphocyte ratio (NLR) was correlated with unfavorable functional outcome in ischemic stroke. However, limited studies have explored the relationship between NLR and single small subcortical infarction (SSSI). This study aims to investigate the link between NLR and functional outcome in patients with SSSI and assess whether white matter hyperintensities (WMH) mediates the relationship between NLR and unfavorable functional prognosis.
Methods
This research analyzed data from patients with SSSI in a Chinese cohort study. The primary outcome was unfavorable functional outcome (modified Rankin Scale score of 2-6) at 90 days after ischemic stroke onset, and the secondary outcome was unfavorable functional outcome at discharge. The relationship between NLR and functional outcome was analyzed using restricted cubic spline (RCS) and multivariable logistic regression. A mediation analysis was conducted to examine the link between NLR and unfavorable functional outcome mediated by WMH.
Results
Among the 513 patients with SSSI included in the study, unfavorable functional outcome was seen in 145 (28.3 %) patients at the 90-day follow-up and 156 patients (30.4 %) at discharge. After controlling for confounding variables, elevated NLR levels were found to be linked with unfavorable functional outcome both at 90 days and at discharge. Mediation analyses indicated that overall WMH significantly mediated the relationship between NLR and unfavorable functional outcome at 90 days and discharge, with mediation proportions of 29.6 % and 24.2 %, respectively. Periventricular WMH accounted for 36.4 % and 32.1 % of the mediation effects, respectively.
Conclusion
Elevated NLR independently increased the risk of unfavorable functional outcome in individuals with SSSI. In patients with SSSI, WMH partially mediated the relationship between NLR and unfavorable functional outcome.
期刊介绍:
The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.