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Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

PURPOSE: To investigate the predictive value of various inflammatory biomarkers in patients with acute ischemic stroke (AIS) and evaluate the relationship between stroke-associated pneumonia (SAP) and the best predictive index. PATIENTS AND METHODS: We calculated the neutrophil-to-lymphocyte ratio (...

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Autores principales: Li, Jingyi, Luo, Haowen, Chen, Yongsen, Wu, Bin, Han, Mengqi, Jia, Weijie, Wu, Yifan, Cheng, Rui, Wang, Xiaoman, Ke, Jingyao, Xian, Hongfei, Liu, JianMo, Yu, Pengfei, Tu, Jianglong, Yi, Yingping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503514/
https://www.ncbi.nlm.nih.gov/pubmed/37720840
http://dx.doi.org/10.2147/CIA.S425393
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author Li, Jingyi
Luo, Haowen
Chen, Yongsen
Wu, Bin
Han, Mengqi
Jia, Weijie
Wu, Yifan
Cheng, Rui
Wang, Xiaoman
Ke, Jingyao
Xian, Hongfei
Liu, JianMo
Yu, Pengfei
Tu, Jianglong
Yi, Yingping
author_facet Li, Jingyi
Luo, Haowen
Chen, Yongsen
Wu, Bin
Han, Mengqi
Jia, Weijie
Wu, Yifan
Cheng, Rui
Wang, Xiaoman
Ke, Jingyao
Xian, Hongfei
Liu, JianMo
Yu, Pengfei
Tu, Jianglong
Yi, Yingping
author_sort Li, Jingyi
collection PubMed
description PURPOSE: To investigate the predictive value of various inflammatory biomarkers in patients with acute ischemic stroke (AIS) and evaluate the relationship between stroke-associated pneumonia (SAP) and the best predictive index. PATIENTS AND METHODS: We calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), prognostic nutritional index (PNI), systemic inflammation response index (SIRI), systemic immune inflammation index (SII), Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), and prognostic index (PI). Variables were selectively included in the logistic regression analysis to explore the associations of NLR, PLR, MLR, PNI, SIRI, SII, GPS, mGPS, and PI with SAP. We assessed the predictive performance of biomarkers by analyzing receiver operating characteristic (ROC) curves. We further used restricted cubic splines (RCS) to investigate the association. Next, we conducted subgroup analyses to investigate whether specific populations were more susceptible to NLR. RESULTS: NLR, PLR, MLR, SIRI, SII, GPS, mGPS, and PI increased significantly in SAP patients, and PNI was significantly decreased. After adjustment for potential confounders, the association of inflammatory biomarkers with SAP persisted. NLR showed the most favorable discriminative performance and was an independent risk factor predicting SAP. The RCS showed an increasing nonlinear trend of SAP risk with increasing NLR. The AUC of the combined indicator of NLR and C-reactive protein (CRP) was significantly higher than those of NLR and CRP alone (DeLong test, P<0.001). Subgroup analyses suggested good generalizability of the predictive effect. CONCLUSION: NLR, PLR, MLR, PNI, SIRI, SII, GPS, mGPS, and PI can predict the occurrence of SAP. Among the indices, the NLR was the best predictor of SAP occurrence. It can therefore be used for the early identification of SAP.
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spelling pubmed-105035142023-09-16 Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke Li, Jingyi Luo, Haowen Chen, Yongsen Wu, Bin Han, Mengqi Jia, Weijie Wu, Yifan Cheng, Rui Wang, Xiaoman Ke, Jingyao Xian, Hongfei Liu, JianMo Yu, Pengfei Tu, Jianglong Yi, Yingping Clin Interv Aging Original Research PURPOSE: To investigate the predictive value of various inflammatory biomarkers in patients with acute ischemic stroke (AIS) and evaluate the relationship between stroke-associated pneumonia (SAP) and the best predictive index. PATIENTS AND METHODS: We calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), prognostic nutritional index (PNI), systemic inflammation response index (SIRI), systemic immune inflammation index (SII), Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), and prognostic index (PI). Variables were selectively included in the logistic regression analysis to explore the associations of NLR, PLR, MLR, PNI, SIRI, SII, GPS, mGPS, and PI with SAP. We assessed the predictive performance of biomarkers by analyzing receiver operating characteristic (ROC) curves. We further used restricted cubic splines (RCS) to investigate the association. Next, we conducted subgroup analyses to investigate whether specific populations were more susceptible to NLR. RESULTS: NLR, PLR, MLR, SIRI, SII, GPS, mGPS, and PI increased significantly in SAP patients, and PNI was significantly decreased. After adjustment for potential confounders, the association of inflammatory biomarkers with SAP persisted. NLR showed the most favorable discriminative performance and was an independent risk factor predicting SAP. The RCS showed an increasing nonlinear trend of SAP risk with increasing NLR. The AUC of the combined indicator of NLR and C-reactive protein (CRP) was significantly higher than those of NLR and CRP alone (DeLong test, P<0.001). Subgroup analyses suggested good generalizability of the predictive effect. CONCLUSION: NLR, PLR, MLR, PNI, SIRI, SII, GPS, mGPS, and PI can predict the occurrence of SAP. Among the indices, the NLR was the best predictor of SAP occurrence. It can therefore be used for the early identification of SAP. Dove 2023-09-11 /pmc/articles/PMC10503514/ /pubmed/37720840 http://dx.doi.org/10.2147/CIA.S425393 Text en © 2023 Li et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Li, Jingyi
Luo, Haowen
Chen, Yongsen
Wu, Bin
Han, Mengqi
Jia, Weijie
Wu, Yifan
Cheng, Rui
Wang, Xiaoman
Ke, Jingyao
Xian, Hongfei
Liu, JianMo
Yu, Pengfei
Tu, Jianglong
Yi, Yingping
Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title_full Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title_fullStr Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title_full_unstemmed Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title_short Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
title_sort comparison of the predictive value of inflammatory biomarkers for the risk of stroke-associated pneumonia in patients with acute ischemic stroke
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503514/
https://www.ncbi.nlm.nih.gov/pubmed/37720840
http://dx.doi.org/10.2147/CIA.S425393
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