Relationship between peripheral blood NLR,D-dimer and short-term prognosis in elderly patients with acute occlusion of intracranial large vessels undergoing endovascular treatment
LIU Jinhui
FAN Qingyu
CAO Liang
ZHAO Jingzhi
WANG Chengkai
Abstract：Objective To analyze the relationship between peripheral blood neutrophil-to-lymphocyte ratio(NLR),D-dimer(DD)and short-term prognosis of stent combined aspiration and embolectomy in elderly patients with acute occlusion of intracranial large vessels and their combined predictive value.Methods A total of 125 elderly patients with acute occlusion of intracranial large vessels treated with stent combined with aspiration and embolectomy from March 2021 to March 2024 were selected.According to the 90-day prognosis after treatment,they were divided into poor prognosis group(n=41)and good prognosis group(n=84).The baseline data and the levels of NLR and DD in peripheral blood before treatment were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between the levels of NLR and DD in peripheral blood before treatment and the National Institutes of Health Stroke Scale(NIHSS)score,and the correlation between NLR and DD was analyzed.Multivariate logistic regression was used to analyze the influencing factors of poor prognosis.The receiver operating characteristic(ROC)curve was used to analyze the value of the time from onset to treatment,NIHSS score before treatment,NLR and DD in peripheral blood in predicting poor prognosis.The interaction between peripheral blood NLR and DD before treatment on poor prognosis was analyzed.Results The poor prognosis rate of elderly patients with acute occlusion of intracranial large vessels was 32.80%(41/125).The time from onset to treatment,NIHSS score before treatment,peripheral blood NLR and DD levels in the poor prognosis group were longer or higher than those in the good prognosis group(P<0.01).The levels of NLR and DD in peripheral blood of elderly patients with acute occlusion of intracranial large vessels before treatment were positively correlated with NIHSS score,and NLR was positively correlated with DD(P<0.05,P<0.01).The time from onset to treatment,NIHSS score before treatment,peripheral blood NLR and DD levels were independent risk factors for poor prognosis in elderly patients with acute occlusion of intracranial large vessels(P<0.01).The area under the curve(AUC)of peripheral blood NLR and DD alone in predicting the poor prognosis of elderly patients with acute occlusion of intracranial large vessels before endovascular treatment was 0.716 and 0.727,respectively.The AUC of multi-factor combination(time from onset to treatment,NIHSS score before treatment,peripheral blood NLR and DD)in predicting poor prognosis was 0.918,which was greater than the AUC predicted by peripheral blood NLR and DD alone before treatment(P<0.01).The interaction analysis showed that the high level of NLR and the high level of DD had a positive interaction in a submultiplicative model for the poor prognosis of elderly patients with acute occlusion of intracranial large vessels(P<0.05).Conclusion Elevated levels of NLR and DD in peripheral blood before treatment are independent risk factors for poor prognosis in elderly patients with acute occlusion of intracranial large vessels.Their combination with the time from onset to treatment and the NIHSS score before treatment can provide a reliable basis for clinical identification of high-risk patients with poor prognosis.
Keywords：acute occlusion of intracranial large vesselsstentaspiration and embolectomyneutrophil to lymphocyte ratioD-dimerprognosiselderly
Publication Date：2025-09-28
Online Publishing Date：2025-10-17(First online date of this platform, not the publication date of the document)
Pages：6( 75-80 )