A Study On The Prognosis Factors Of Short-term With Acute Ischemic Stroke And The Correlation With The Ratio Of Neutrophil To Lymphocyte

Objective From the collection of basic information on patients with Acute Ischemic Stroke(AIS)admitted to hospital,indicators of the first clinical test,stroke-related prognostic factors,and m RS Scores from patients 3 months after discharge,the current study collected additional information from ischemic stroke patients.To analyze the factors influencing the short-term prognosis of patients with acute ischemic stroke and the correlation between the ratio of neutrophil and lymphocyte upon admission,so as to provide more reference for clinicians and scientific basis for the treatment of patients with acute ischemic stroke and secondary prevention.Methods In strict accordance with the inclusion and exclusion criteria,1740 patients with acute ischemic stroke from Chaoyang Central Hospital were collected from 2018 to2019 for questionnaire survey,physical examination and laboratory testing.The patients were followed up 3 months after discharge.The risk factors affecting the poor prognosis of AIS patients were analyzed by binary Logistic single and multi-factor regression analysis models.Results1.A total of 1500 subjects were included in this study,of which 133 were disabled,and the disability rate was 8.9%,with female higher than male(11.4%vs7.4%),and the difference was statistically significant(P < 0.05).The m RS Score of acute ischemic patients at 3 months after discharge was 1.24±1.27,including 1.22±1.21 for male and 1.28±1.37 for female.The m RS Score of AIS patients less than 50 years old at 3 months after discharge was 0.95±1.08,including1.00±1.17 males and 0.68±0.65 females.The m RS Score of AIS patients aged 50-59 at 3 months after discharge was 1.09±1.14,with 1.10±1.09 for male and 1.05±1.28 for female.The m RS Score of AIS patients aged 60-69 at 3 months after discharge was 1.29±1.27,including 1.26±1.23 males and 1.34±1.33 females.The m RS Score of70-79 year old AIS patients at 3 months after discharge was 1.36±1.38,including1.30±1.24 male and 1.45±1.55 female.The m RS Score of AIS patients over 80 years old at 3 months after discharge was 1.48±1.38,including 1.51±1.41 for males and1.43±1.35 for females,with no statistical significance.2.NLR patients were divided into 4 groups by quartile method.Group Q1:281cases with NLR ≤ 1.63 and 19 cases with disability,with disability rate of 6.8%,male3.8% and female 10.7%,the difference was statistically significant(P < 0.05).Group Q2: There were 373 cases of 1.64 ≤ NLR ≤ 2.30,29 cases of disability,the disability rate was 7.8%,male 8.6%,female 7.1%,the difference was not statistically significant;In Q3 group,374 cases were 2.31 ≤ NLR ≤ 3.31,and 26 cases were disabled,with a disability rate of 7.0%,4.2 males and 13.3 females,and the difference was statistically significant(P < 0.05).Q4 group: There were 369 cases with NLR ≥ 3.32 and 53 cases with disability,the disability rate was 14.4%,13.6males and 16.2 females,the difference was not statistically significant(P > 0.05).3.Multivariate Logistic regression results of AIS patients’ prognosis showed that in the advanced age group(compared with the < 50 age group,70-79 years old OR=3.95,95%CI: 1.54-10.15;≥80 years old OR=5.66,95%CI: 2.11-15.17),hypertension(OR=1.59,95% CI: 1.06-2.37),diabetes(OR=1.90,95%CI: 1.28-2.83),atrial fibrillation(OR=3.03,95% CI: 1.41-6.49),neutrophils(OR=1.02,95%CI:1.41-6.49),NLR(compared to the NLR first quantile,the NLR fourth quantile:OR=2.28,95%CI: 1.32-3.95,P < 0.05)were the main risk factors for poor prognosis in patients with AIS 3 months after discharge.Multivariate Logistic regression showed poor prognosis in male AIS patients in the higher age group(compared with the < 50 age group,70-79 years old: OR=3.16,95%CI: 1.07-9.35;≥ 80 years old:OR=5.33,95%CI: 1.71-16.61),hypertension(OR=1.69,95%CI: 1.00-2.86),NLR(compared with the first group of NLR,the fourth group of NLR: OR=2.28,95%CI:1.32-3.95,P < 0.05)were risk factors for poor prognosis of AIS patients after 3months of discharge.Multivariate Logistic regression results of prognosis in female AIS patients showed that diabetes mellitus was a risk factor for poor prognosis in AIS patients,and the difference was statistically significant(P < 0.05).Conclusion Factors related to poor prognosis in AIS patients at 3 months after discharge were age increasing,diabetes mellitus,atrial fibrillation,neutrophils,and the fourth subgroup of NLR;factors related to poor prognosis in male AIS patients at 3 months after discharge were age increasing,hypertension,and the fourth subgroup of NLR;factors related to poor prognosis in female AIS patients at 3 months after discharge were diabetes.This study evaluated the relationship between NLR at admission and poor prognosis 3 months after discharge of AIS patients,and found that NLR at admission was correlated with the short-term prognosis of patients with acute ischemic stroke.In summary,males,increasing age,education of high school or above,hypertension,diabetes,atrial fibrillation,current smoking,current alcohol consumption,blood uric acid,neutrophil-granulocyte count,and NLR were associated with poor prognosis 3 months after discharge in AIS patients.