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Original Article



The effect of neutrophil lymphocyte ratio on mortality in patients followed in the intensive care unit with the diagnosis of ischemic stroke from the emergency department

Hakan Aygun, Asli Sener.




Abstract

The goal of this study was to determine if the neutrophil-lymphocyte ratio (NLR) predicts mortality in patients hospitalized in the intensive care unit (ICU) with an ischemic stroke. Between January 1 and December 31, 2021, 116 patients admitted to our emergency department with the diagnosis of ischemic stroke and hospitalized in the 3rd level ICU unit were included in the study and divided into two groups: patients who died (Group 1: n=62) and patients who survived (Group 2: n=54). Patients’ age, gender, presence of chronic diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and neutrophil count, lymphocyte count, and NLR were obtained by dividing these two numbers in the first complete blood count taken at the time of admission to the emergency department were collected and analyzed. While 54 (46.5%) patients were discharged from the ICU, 62 (53.4%) patients died. 60 (51.7%) of the patients were female. The average age of patients was 76.85±10.70. APACHE II score was found to be correlated with mortality (AUC 0.70, 95% CI (0.616-0.802) (p=0.01). When the APACHE II cut-off value was more than 13.5, it predicted mortality with 95% sensitivity and 85% specificity. The median NLR ratio of the patients was found to be 5.08 (0.38-35.16) in the survivors and 11.68 (1.38-113.00) in patients that died. NLR was lower in survivors (p=0.002). NLR may be a valuable marker in predicting mortality in stroke patients admitted to the ICU.

Key words: Ischemic stroke, intensive care, neutrophil-lymphocyte ratio






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