Prognostic role of neutrophil–lymphocyte ratio in patients with acute ischemic stroke

BACKGROUND: The aim of this study was to evaluate the prognostic role of neutrophil–lymphocyte ratio (NLR) in patients with acute ischemic stroke (AIS). METHODS: PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure were searched for potential eligible literature. The study characteristics and relevant data were extracted. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to estimate the prognostic role of NLR in patients with AIS. Poor functional outcome was defined as modified Rankin Scale ≥ 3. RESULTS: Nine studies with 2947 patients were included. The pooled OR of higher NLR for poor functional outcome at 3 months was 1.55 (95% CI, 1.21–2.00). The pooled ORs for death at 3 months, poor functional outcome at discharge, and symptomatic intracranial hemorrhage (sICH) were 2.35 (95% CI, 0.40–13.78), 2.38 (95% CI, 0.49–11.69), and 4.32 (95% CI, 2.46–7.61), respectively. CONCLUSION: For patients with AIS, higher NLR was associated with poorer functional outcome at 3 months and may be associated with a higher risk of developing sICH. This readily available and inexpensive marker may be helpful in future clinical and research work. However, due to the limited number of included studies, more well-designed studies are warranted to further clarify this issue.