Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Poststroke Depression: A Systematic Review and Meta-Analysis

Abstract

Objectives. Evidence shows that stroke-induced inflammatory responses play an essential role in the development of poststroke depression (PSD). The goal of this systematic review and meta-analysis was to critically evaluate the literature regarding the use of the neutrophil to lymphocyte ratio (NLR) as a reliable means to detect early PSD development, to help clinicians institute early interventions and improve outcomes. Methods. Electronic databases, including Web of Science, PubMed, Google Scholar, and Scopus, were searched, and eight studies were included. We assessed the certainty of the associations with GRADE methods. Results. We found that patients with PSD had higher NLR than the stroke patients with no depression ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mtext>SMD</a:mtext> <a:mo>=</a:mo> <a:mn>0.51</a:mn> </a:math> ; <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mtext>CI</c:mtext> <c:mtext> </c:mtext> <c:mn>95</c:mn> <c:mi>%</c:mi> <c:mo>=</c:mo> <c:mn>0.29</c:mn> </c:math> -0.73, <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>p</e:mi> <e:mo>&lt;</e:mo> <e:mn>0.001</e:mn> </e:math> ). Also, we found a significantly higher PLR in the patients with PSD when compared to the stroke patients with no depression ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mtext>SMD</g:mtext> <g:mo>=</g:mo> <g:mn>0.66</g:mn> </g:math> ; <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mtext>CI</i:mtext> <i:mtext> </i:mtext> <i:mn>95</i:mn> <i:mi>%</i:mi> <i:mo>=</i:mo> <i:mn>0.19</i:mn> </i:math> -1.13, <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>p</k:mi> <k:mo>&lt;</k:mo> <k:mn>0.001</k:mn> </k:math> ). Conclusion. These findings indicated that NLR and PLR could be considered inexpensive biomarkers for the prediction of PSD.

Topics & Concepts