Establishment of a serum NLR combined with AGI grading model to predict clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment
FAN Wen-ding
WU Xi
SU Yi
WU Qing-yu
WU Zhi-xin
WEI Si-yuan
QIU Fu-cheng
LING Hao
LI Ling-zhi
LIANG Yong-tong
Abstract：Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR)combined with Acute Gastrointestinal Injury(AGI)grading for the clinical outcomes of patients with acute ischemic stroke(AIS)undergoing endovascular treatment(EVT).Methods A retrospective analysis was conducted on AIS patients treated with EVT at a stroke center.Patients were categorized into good prognosis group(mRS≤2)and poor prognosis group(mRS＞2)based on Modified Rankin Scale(mRS)scores 90 days post-surgery.Clinical data and TCM syndrome dif-ferentiation were collected for both groups.Preoperative NLR was calculated,and the highest AGI grade within 1 week of admission was recorded for statistical analysis.Risk factors for poor prognosis after EVT in AIS patients were studied,and logistic regression was employed for analysis.Receiver operating characteristic(ROC)curves were also plotted to evaluate the predictive value of NLR combined with AGI grading for the prognosis of AIS patients undergoing EVT.Results A to-tal of 164 patients were included,with 89(54.3％)in the good prognosis group and 75(45.7％)in the poor prognosis group.Patients in the poor prognosis group had higher age,NIH Stroke Scale(NIHSS)scores at admission,total hospi-talization costs,prevalence of hypertension,triglyceride levels,urea levels,NLR levels,incidence of pneumonia,and AGI grade compared to those in the good prognosis group(all P＜0.05).The proportion of stroke phlegm obstruction syn-drome was higher in the poor prognosis group than in the survival group(P＜0.05).Multivariable logistic regression anal-ysis showed that NLR(OR=1.121,95％CI:1.025-1.227,P=0.012),severity of AGI(OR=1.936,95％CI:1.233-3.040,P=0.004),urea levels(OR=1.343,95％CI:1.036-1.741,P=0.026),stroke phlegm obstruc-tion syndrome(OR=3.335,95％CI:1.136-9.568,P=0.025),and occurrence of pneumonia(OR=4.529,95％CI:1.444-14.210,P=0.010)were independent risk factors for poor outcomes after EVT in AIS patients.ROC curve analysis showed that the area under the curve for the combined evaluation of NLR and AGI grading in predicting poor prog-nosis after EVT in patients with acute ischemic stroke was greater than that for NLR or AGI grading alone.Conclusion NLR and AGI have certain predictive value for the prognosis evaluation of AIS patients undergoing EVT,and their combi-nation can enhance the predictive value.
Keywords：acute ischemic strokeendovascular treatmentneutrophil-to-lymphocyte ratioacute gastroin-testinal injury classificationprognosis
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 583-589 )