Elevated neutrophil‑to‑lymphocyte and platelet‑to‑lymphocyte ratios predict post‑stroke depression with acute ischemic stroke
Jia Hu, Wei Zhou, Zhiming Zhou, Jian Han, Wanli Dong
Abstract
Post‑stroke depression (PSD) is the most prevalent psychiatric complication of acute ischemic stroke. The neutrophil‑to‑lymphocyte ratio (NLR) and the platelet‑to‑lymphocyte ratio (PLR) are indicators of inflammation and are associated with stroke and depression. Therefore, the purpose of the present study was to examine the relationship between NLR/PLR and PSD. Retrospective analysis was carried out in 376 patients with first‑ever acute ischemic stroke in the First Affiliated Yijishan Hospital of Wannan Medical College between March 2015 and September 2017. Patients were divided into PSD (n=104; 27.7%) and non‑PSD (n=272; 72.3%) groups according to the Diagnostic and Statistical Manual of Mental Disorders‑IV criteria at 6 months after stroke. Clinical data were collected retrospectively. NLR and PLR were acquired retrospectively from the routine blood tests performed at admission. A total of 120 healthy volunteers from the physical examination center in the First Affiliated Yijishan Hospital of Wannan Medical College were recruited as controls. Using logistic regression analysis, NLR (≥4.02) and PLR (≥203.74) were independently associated with PSD. NLR, odds ratio (OR) 3.926, 95% confidence intervals (CI, 2.365‑7.947), P<0.001; PLR, OR 3.853, 95% CI (2.214‑6.632), P=0.002. The ability of the combined index [area under the receiver operating characteristic curve, 0.701; 95% CI (0.622‑0.780); P<0.001] to diagnose PSD was greater than that of either ratio alone. Higher NLRs and PLRs (≥4th quartile) were associated with PSD with a 5.79‑fold (P<0.001) increase compared with lower levels of both. Higher NLRs and PLRs were found to be associated with depression 6 months after stroke, and the combined index was more meaningful than either alone in the early clinical detection of PSD.