doi: 10.2174/0115672026328594240614080241.
Neutrophil-to-albumin Ratio as a Prognostic Factor in Patients with Acute Ischemic Stroke
Affiliations
- PMID: 38918991
- PMCID: PMC11774307
- DOI: 10.2174/0115672026328594240614080241
Item in Clipboard
Neutrophil-to-albumin Ratio as a Prognostic Factor in Patients with Acute Ischemic Stroke
Curr Neurovasc Res.
2024.
Abstract
Background: Neutrophil-To-Albumin Ratio (NAR) is a novel inflammatory biomarker. However, the potential prognostic value of NAR in acute ischemic stroke (AIS) remains unclear. This study aimed to evaluate whether NAR levels correlated with the 3-month modified Rankin scale (mRS) in patients with AIS.
Methods: AIS patients were included in this retrospective study. NAR was calculated as the ratio of absolute neutrophil count to serum albumin level. Logistic regression analyses were used to investigate the effect of NAR on 3-month mRS of AIS. The predictive values of NAR, albumin level, and neutrophil count were compared utilizing receiver operating characteristic (ROC) curves. Moreover, subgroup analyses and interaction tests were conducted to evaluate the consistency of NAR's effect on AIS prognosis.
Results: Of the 780 patients included, 403 (51.67%) had a poor clinical outcome (mRS 3-6) at 3 months. NAR was independently correlated to 3-month poor functional outcome after adjusting for confounders (Odds ratios (OR), 9.34; 95% confidence intervals (CI), 1.09 to 80.13; p =0.0417). Subgroup analysis showed a relative effect consistent with the overall population results, and no statistical interactions were found in the subgroups (all p for interaction > 0.05). The ROC curve showed that the prognosis-related cutoff value for NAR was 0.123, with corresponding specificity and sensitivity of 53.55% and 63.94%, respectively. When comparing the predictive power, NAR (0.590; 95%CI 0.549-0.630) exhibited the highest area under the curve (AUC) of ROC compared to neutrophils (0.584; 95%CI 0.543-0.624) and albumin (0.540; 95%CI 0.500-0.581).
Conclusion: There is a positive relationship between NAR levels and 3-month poor functional outcomes in AIS patients, supporting the potential of NAR as a readily available and economic serum biomarker for the early identification of AIS prognosis. Further studies are required to validate the prognostic value and clinical utility of the NAR.
Keywords: AIS; NAR; Neutrophil-to-albumin ratio; inflammatory biomarker; prognosis; receiver operating characteristic; serum biomarker..
Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
Conflict of interest statement
The authors declare no conflict of interest, financial or otherwise.
Figures
Flowchart of the patient selection. A total of 780 patients were included in this study. Abbreviation: mRS=modified Rankin scale.
Subgroup analyses and interaction tests of the association between NAR and 3-month poor clinical outcome in AIS patients. No significant interactions were observed across subgroups, including age, gender, stroke severity, stroke subtypes, hemorrhagic transformation, smoking status, occlusion site, and treatments after admission. This suggested that the relationship between NAR and 3-month functional outcomes was stable across our study population. Abbreviations: OR=odds ratio; CI=confidence interval; EVT=endovascular treatment.
ROC curve and AUC showing the predictive ability of NAR, neutrophil, and albumin for 3-month poor clinical outcome in AIS patients. NAR demonstrated the highest AUC compared to either neutrophil or albumin levels alone, suggesting that NAR is more effective as a prognostic indicator. Abbreviations: NAR=Neutrophil-to-Albumin Ratio; ROC=receiver operating characteristic; AUC=area under the ROC curve.
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