Abstract Details

Identify the systemic inflammation indexes mostly associated with the severity and functional prognosis of ischemic stroke.                                                                                              

The inflammatory response is involved in all stages of brain infarction, starting in the early stage of cellular necrosis due to the interruption of cerebral blood flow until recovery and repair of post-ischemic tissue in the late stage. Various markers have been described that are related to inflammatory diseases, such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and the systemic immuno-inflammation index (SII).

Prospective study, cases with ischemic stroke confirmed by neuroimaging and who had hemogram at admission, included in iReNe (i-Neurovascular Registry), from January-2018 to June-2019, hospitalized in the Neurovascular Care Unit of the Service of Neurology, University Hospital “Dr. José E. González”. For the analysis, they were divided into 2 groups according to the severity of the infarction at admission (NIHSS <6 and ≥6) and the functional prognosis at 30 days (mRS ≤3 and >4). Cuts-off were made for inflammatory markers by an analysis of the receiver's characteristic operating curve and the Youden index.

145 patients were included, 97(66.8%) men, average age 61(±12.77). The groups with NIHSS ≥6 and mRS >4 reported higher levels of NLR, PLR and SII (p<0.01). The NIHSS at admission and the mRS at 30 days was positively correlated with the values of NLR (r= 0.233, p= 0.007), PLR (r=0.273, p=0.002), SII (r=0.316, p<0.001) and NLR (r=0.270, p=0.015), PLR (r=0.271, p=0.022) and SII (r=0.254, p=0.023) respectively. SII >623.71 were associated with NIHSS ≥6 (p=0.012) and mRS at 30 days (p=0.011) in the multivariate analysis.

This is the first study that associates SII and ischemic stroke. The systemic inflammation indexes could be a fast and low-cost marker for initial evaluation in patients with ischemic stroke, which results would help to stratify their severity and prognosis.