Neutrophil/lymphocyte and platelet/lymphocyte ratios in acute cerebrovascular disease. Evaluation of utility in predicting hemorrhagic transformation.

Abstract

Objective: To associate the Neutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) with hemorrhagic ransformation (HT) in Ischemic Stroke (IS) in neurocritical patients.
Design: Retrospective, analytical, observational, cross-sectional study.
Scope: Neurocritical Care Unit of the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
Patients: Adults > 18 years of age with acute ischemic CVD, hospitalized from January 1, 2021 to December 31, 2021, selected by non-probabilistic convenience sampling.
Intervention: Identification of HT in a neuroimaging study, determination of functional status and mortality at 30 and 90 days. The cut-off AUC for HT prediction was established. With logistic regression and multivariate analysis, other factors associated with HT were determined.
Primary endpoint: Hemorrhagic transformation related to INL and IPL and with mRS at 30 and 90 days.
Results: 188 patients were included. The prevalence of HT was 12.8%. Mortality in HT at 30 days was 16.7%. The mean NLR was 5.81 (SD + 6.29), OR 1.33 (95% CI 0.65-2.69; p = 0.42) and value > 4.67 (S: 66.7 %-E: 63.2%), AUC 0.67, predicted TH. NLR > 3.46 predicted mRS 5-6 at 90 days, adj OR 2.57 (95% CI 1.48- 4.67; p = 0.001), AUC 0.74. The mean IPL was 192 (SD + 150), without reaching predictive capacity. Glycemia >140 mg/dL was associated with HT.
Conclusions: The NLR was associated in a directly proportional way with the increased risk of HT and with worse functional results at 90 days. PLR showed no association.