Baseline Neutrophil Counts and Neutrophil Ratio May Predict a Poor Clinical Outcome in Minor Stroke Patients with intravenous Thrombolysis.

Background: Evidence about whether neutrophil counts, neutrophil ratio linked with clinical outcome in patients with minor stroke after thrombolysis is scarce. The purpose of this study is to explore the association of neutrophil counts, neutrophil ratio with the 90-day clinical outcome in patients with minor stroke treated with intravenous thrombolysis. Materials and methods: A total of 163 patients with minor stroke treated with thrombolysis within window time were recruited from 2013 to 2017. Their total neutrophil and leukocyte counts on admission were measured. Disability or death (defined as a modified Rankin scale score ≥2) at 90-day were captured. Multiple logistic regression models were used to estimate the association between neutrophil counts, and neutrophil ratio to clinical outcome. Receiver operating characteristic curves were used to evaluate the predictive value of neutrophil counts or neutrophil ratio. Results: At the 90-day follow-up, 36 patients (21%) had disability or death after stroke onset. Compared to the first tertile, the higher neutrophil counts increased the risk of 90-day disability or death (adjusted odds ratio [aOR] for third tertile: 2.93 (1.08-7.96); P for trend = .03). Similarly, higher neutrophil ratio also increased the risk of disability or death (aOR for third tertile: 5.81 (1.7-19.88); P for trend = .005). The comparison of area under the curve for neutrophil ratio versus neutrophils was .1 (P = .04). Thus, neutrophil ratio with the cutoff point of .74 had a better discriminative ability to the outcome (6.11, 2.36-15.86). Conclusions: Baseline higher neutrophil counts and neutrophil ratio were associated with an increased risk of 90-day disability or death in patients with minor stroke who received thrombolytic therapy.