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Research Article
Zhongxin Xu
China-Japan Union Hospital of Jilin University
Corresponding Author
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Background: The neutrophil to lymphocyte ratio (NLR) has been shown to be an important independent inflammatory indicator in stroke. The relationship between NLR and poor prognostics in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT) still unclear. The purpose of this meta-analysis was to evaluate the association between NLR and poor prognosis after IVT. Furthermore, we aim to concluded whether admission NLR or post-IVT NLR play a role in AIS.
Methods: Pubmed, Embase, Wed of Science and China National Knowledge Infrastructure were searched for relevant articles until October 7, 2020. Cohort and case-control studies were included if related to NLR in AIS patients treated with IVT. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were pooled to estimate the relationship between NLR and poor prognosis after IVT. A random effects model was used to calculate the pooled data.
Results: Twelve studies, including 3641 patients met the predefined inclusion criteria. Higher NLR levels were associated with an increased risk of hemorrhagic transformation (HT) (OR=1.33,95%CI=1.14-1.56, P<0.001) and 3-month poor functional outcome (OR=1.64,95%CI=1.38-1.94, P<0.001) in AIS patients receiving IVT. Subgroup analysis of HT suggested that admission NLR levels rather than post-IVT NLR levels was associated with higher risk of HT (OR=1.33,95%CI=1.01-1.75, P=0.039). But There had no statistically significant difference between higher NLR levels and 3-month mortality (OR=1.14, 95%CI=0.97-1.35, P=0.120).
Conclusions: High NLR can predict HT and 3-month poor functional outcome in AIS patients received IVT. Admission NLR rather than post-IVT NLR was independent risk factor of increased risk of HT.
Keywords
acute ischemic stroke, neutrophil to lymphocyte ratio, intravenous thrombolysis, hemorrhagic transformation, functional outcome, meta-analysis
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Figure 4
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
- TableS1.docx
Additional file 1: Table S1. Publication bias assessment with Egger test for HT and functional outcome.
- FigureS1.docx
Additional file 2: Figure S1. Sensitivity analysis for HT.
- FigureS2.docx
Additional file 3: Figure S2. Sensitivity analysis for functional outcome.
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CURRENT STATUS: Under Review
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Posted 13 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 23 Mar, 2021
Reviews received
Received 09 Mar, 2021
Reviews received
Received 20 Feb, 2021
Reviews received
Received 16 Feb, 2021
Reviews received
Received 12 Feb, 2021
Reviewers agreed
On 08 Feb, 2021
Reviewers agreed
On 05 Feb, 2021
Reviewers agreed
On 04 Feb, 2021
Reviewers invited
Invitations sent on 04 Feb, 2021
Editor assigned
On 04 Feb, 2021
Editor invited
On 04 Feb, 2021
Submission checks complete
On 04 Feb, 2021
First submitted
On 30 Jan, 2021
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Subject Areas
Neurology
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This preprint is under consideration at BMC Neurology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Zhongxin Xu
China-Japan Union Hospital of Jilin University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 13 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 23 Mar, 2021
Reviews received
Received 09 Mar, 2021
Reviews received
Received 20 Feb, 2021
Reviews received
Received 16 Feb, 2021
Reviews received
Received 12 Feb, 2021
Reviewers agreed
On 08 Feb, 2021
Reviewers agreed
On 05 Feb, 2021
Reviewers agreed
On 04 Feb, 2021
Reviewers invited
Invitations sent on 04 Feb, 2021
Editor assigned
On 04 Feb, 2021
Editor invited
On 04 Feb, 2021
Submission checks complete
On 04 Feb, 2021
First submitted
On 30 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The neutrophil to lymphocyte ratio (NLR) has been shown to be an important independent inflammatory indicator in stroke. The relationship between NLR and poor prognostics in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT) still unclear. The purpose of this meta-analysis was to evaluate the association between NLR and poor prognosis after IVT. Furthermore, we aim to concluded whether admission NLR or post-IVT NLR play a role in AIS.
Methods: Pubmed, Embase, Wed of Science and China National Knowledge Infrastructure were searched for relevant articles until October 7, 2020. Cohort and case-control studies were included if related to NLR in AIS patients treated with IVT. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were pooled to estimate the relationship between NLR and poor prognosis after IVT. A random effects model was used to calculate the pooled data.
Results: Twelve studies, including 3641 patients met the predefined inclusion criteria. Higher NLR levels were associated with an increased risk of hemorrhagic transformation (HT) (OR=1.33,95%CI=1.14-1.56, P<0.001) and 3-month poor functional outcome (OR=1.64,95%CI=1.38-1.94, P<0.001) in AIS patients receiving IVT. Subgroup analysis of HT suggested that admission NLR levels rather than post-IVT NLR levels was associated with higher risk of HT (OR=1.33,95%CI=1.01-1.75, P=0.039). But There had no statistically significant difference between higher NLR levels and 3-month mortality (OR=1.14, 95%CI=0.97-1.35, P=0.120).
Conclusions: High NLR can predict HT and 3-month poor functional outcome in AIS patients received IVT. Admission NLR rather than post-IVT NLR was independent risk factor of increased risk of HT.
Figure 1
Figure 2
Figure 3
Figure 4
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
- TableS1.docx
Additional file 1: Table S1. Publication bias assessment with Egger test for HT and functional outcome.
- FigureS1.docx
Additional file 2: Figure S1. Sensitivity analysis for HT.
- FigureS2.docx
Additional file 3: Figure S2. Sensitivity analysis for functional outcome.
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