• World Neurosurg · Oct 2024

    Neutrophil-to-Lymphocyte Ratio is Associated with Clinical Outcomes in Patients Treated with Mechanical Thrombectomy for Posterior Circulation Large Vessel Occlusion.

    • Huanqing Shi, Hongfei Sang, Zheng Zhang, Biao Chen, Lingfei Li, Fei Liu, Wenqing Xia, Yongji Zhou, Keqin Liu, Xiaoqin Li, Congguo Yin, and Lin Jiang.
    • The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China.
    • World Neurosurg. 2024 Oct 16.

    ObjectiveTo investigate the potential of composite inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), in predicting outcomes in patients with posterior circulation large vessel occlusion who underwent mechanical thrombectomy (MT).MethodsWe included patients who underwent MT for posterior circulation large vessel occlusion between February 2016 and December 2021. We then assessed composite inflammatory markers on day 1 post-MT. The primary outcome was the modified Rankin Scale score at 3 months (favorable score: 0 -3). The primary safety measure was 3-month mortality. Receiver operating characteristic (ROC) curve analysis determined each marker's predictive values and optimal cutoff values. Multivariable regression analysis assessed the relationship between markers and outcomes.ResultsWe included a total of 137 patients (median age: 71 years, 26% females, median National Institutes of Health Stroke Scale [NIHSS] score: 23). NLR demonstrated the best predictive value for the prognosis of patients with posterior circulation large vessel occlusion who underwent MT. ROC analysis identified an optimal NLR cutoff of 12.5 (area under curve [AUC]: 0.741, 95% confidence intervals [CIs]: 0.652-0.830) for favorable outcomes and 14.1 (AUC: 0.764, 95% CIs: 0.662-0.865) for predicting death. Multivariate analysis determined an NLR <12.5 as an independent predictor of favorable post-MT outcomes (odds ratio [OR]: 10.43, 95% CIs: 3.85-28.29, p <0.001), and NLR <14.1 as an independent predictor of post-MT survival (OR: 0.09, 95% CIs: 0.03-0.25, p <0.001).ConclusionsAmong the assessed markers, NLR emerged as the strongest predictor of clinical outcomes following MT for posterior circulation large vessel occlusion.Copyright © 2024. Published by Elsevier Inc.

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