Title:Neutrophil-to-lymphocyte Ratio Predicts the Outcome of Cerebral Venous Thrombosis
Volume: 18
Issue: 2
Author(s): Jiawei Zhao, Kai Liu, Shen Li, Yuan Gao, Lu Zhao, Hongbing Liu, Hui Fang, Bo Song*Yuming Xu*
Affiliation:
- Department of Neurology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan,China
- Department of Neurology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan,China
Keywords:
Neutrophil-to-lymphocyte ratio, cerebral venous thrombosis, prognosis, mortality, predictors, Cerebral Venous
Thrombosis (CVT).
Abstract:
Background: Increasing evidences suggest that Neutrophil-to-Lymphocyte Ratio (NLR)
is an independent predictor of poor prognosis in patients with cardiovascular disease. However, the
relationship between NLR and prognosis in patients with Cerebral Venous Thrombosis (CVT) has
not been studied.
Methods: Consecutive CVT patients from November 2011 through April 2019 were retrospectively
identified. Poor outcome was defined as a modified Rankin Scale (mRS) of 3-6. Multivariate regression
analysis was conducted to assess the relationship between total and differential leukocyte
counts, NLR and clinical outcome in CVT patients. The Receiver Operating Characteristic (ROC)
analysis was further performed to evaluate the ability to predict mortality, and subgroup analysis
was conducted to explore the potential interaction effects.
Results: A total of 360 CVT patients were included, and the median duration of follow-up was 9.0
months. Multivariate logistic regression analysis suggested that NLR value, as a continuous variable,
was significantly associated with a high risk of poor outcome (adjusted odds ratio [OR]=1.06,
95% confidence intervals [CI] 1.01-1.11, P = 0.013) and mortality (adjusted OR = 1.08; 95% CI,
1.03-1.14; P = 0.002). Compared with the total and differential leukocyte counts, the best discriminating
variable to predict the risk of mortality was NLR, and the area under the receiver operating
curve was 0.81. The optimal cut-off value of NLR to predict mortality was 5.6 (sensitivity 84.2%,
specificity 69.9%). Multivariate Cox regression analysis indicated that the mortality rate was significantly
higher in patients with a high NLR level group (>5.6) (adjust hazard ratio=5.65, 95% CI
2.33-12.73, P<0.001). There was no potential heterogeneity in the further subgroup analysis across
age (above vs. below 45 years old), sex, history of infections and pregnancy/postpartum, presence
of coma and intracerebral hemorrhage.
Conclusion: Elevated NLR value is associated with a high risk of poor outcomes in CVT patients.
