Combination of neutrophil to lymphocyte ratio, NIHSS score and collateral circulation Tan score predicts the outcome of intravenous thrombolysis in patients with anterior circulation large vessel occlusive stroke / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the predictive value of baseline peripheral blood neutrophil to lymphocyte ratio (NLR), National Institutes of Health Stroke Scale (NIHSS) score combined with collateral circulation Tan score for the outcome of intravenous thrombolysis in patients with acute anterior circulation large vessel occlusive stroke.Methods:Patients with acute anterior circulation large vessel occlusive stroke received alteplase intravenous thrombolysis in the Departmet of Neurology, the Second Affiliated Hospital of Anhui Medical University from January 2019 to May 2021 were enrolled retrospectively. The modified Rankin Scale score was used to evaluate the outcomes at 90 d after thrombolysis. 0-2 was defined as good outcome and 3-6 were defined as poor outcome. The demographics, clinical data and imaging data between the good outcome group and the poor outcome group were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome of thrombolysis, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR, NIHSS score, Tan score and their combination on the outcome of intravenous thrombolysis. Results:A total of 118 patients with acute anterior circulation large vessel occlusive stroke were enrolled during the study. Their age was 67.73±11.91 years, and there were 71 males (60.2%). Fifty-eight patients (49.2%) were in the good outcome group and 60 (50.8%) were in the poor outcome group. Univariate analysis showed that there were significant differences in NLR, collateral circulation Tan score and baseline NIHSS score between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that NLR (odds ratio [ OR] 1.299, 95% confidence interval [ CI] 1.005-1.679; P=0.046), baseline NIHSS score ( OR 1.150, 95% CI 1.037-1.275; P=0.008), collateral circulation Tan score ( OR 0.298, 95% CI 0.160-0.556; P<0.001) were independently associated with the outcomes. ROC curve analysis showed that the areas under the curve of NLR, baseline NIHSS score, Tan score and their combination for predicting poor outcome were 0.640, 0.752, 0.823 and 0.870, respectively. Conclusions:Peripheral blood NLR before thrombolysis, baseline NIHSS score and collateral circulation Tan score could predict the outcomes after intravenous thrombolysis in patients with acute anterior circulation large vessel occlusive stroke, and the combination of the three had a higher predictive value.