Association between neutrophil percentage-to-albumin ratio and 3-month functional outcome in acute ischemic stroke patients with reperfusion therapy
Ting Cui, Changyi Wang, Qiange Zhu, Shucheng Li, Yuan Yang, Anmo Wang, Xuening Zhang, Wenzuo Shang, Bo Wu
Abstract
Background Neutrophils and albumin are associated with outcomes in patients with acute ischemic stroke (AIS). We aimed to explore the association between the neutrophil percentage-to-albumin ratio (NPAR), a novel marker of inflammation and oxidative stress, and the 3-month functional outcome in AIS patients with reperfusion therapy. Methods This single-center, retrospective cohort study consecutively enrolled AIS patients with reperfusion therapy. Neutrophils and albumin were collected on admission. The primary outcome was a poor functional outcome, which was defined as a modified Rankin scale score of 3–6 at 3 months. Results A total of 647 patients with AIS who received reperfusion therapy were analyzed. The mean age was 68.9 ± 13.9 years, and 358 (55.3%) of the patients were men. The median NPAR was 1.89 (interquartile range [IQR] 1.64–2.09). The percentage of patients with a 3-month poor functional outcome was 57.0% (369/647). NPAR was positively associated with a poor functional outcome (odds ratio [ OR ] 2.76, 95% CI : 1.52–5.03, p = 0.001). When patients were classified into tertiles, patients in the upper tertile (2.03–7.59) had a higher risk of poor outcome than patients in the lower tertile after adjusting for potential confounders (0.78–1.73) ( OR 2.10, 95% CI : 1.28–3.42, p = 0.003). The risk of poor outcome increased with NPAR tertiles ( p -trend = 0.003). The optimal cut-off value of the NPAR for predicting a poor outcome was 1.72, with a sensitivity of 0.75, and a specificity of 0.43. Conclusion Neutrophil percentage-to-albumin ratio was significantly associated with 3-month poor functional outcomes in patients with AIS who received reperfusion therapy.