Background: One factor that plays a role in the pathophysiology of stroke is inflammation, inflammation is a response to injury to living tissue that has vascularization. The brain responds to ischemic events through microglia activation with proinflammatory mediator production causing infiltration of various inflammatory cells such as neutrophils, lymphocytes and monocytes to brain tissue. The role of a significant inflammatory marker in assessing the course of ischemic
stroke, one of which is the neutrophil lymphocyte ratio (NLR) that combines neutrophils as an active inflammatory component and lymphocytes as regulators and protective components in a single parameter. The NLR assessment is expected to indicate the degree of severity of ischemic stroke based on National Institutes of Health Stroke Scale (NIHSS) scores.
Objective: To determine the correlation between NLR value and stroke severity in ischemic stroke patients.
Methods: A cross-sectional study was conducted at Atma Jaya Hospital from January 2016 to October 2017 using a medical record of 60 samples of ischemic stroke patients
and 160 healthy control samples.
Results: In stroke patients obtained NLR with median 3.32 and in healthy control, NLR was obtained with mean 1.34. This differences in NLR values indicates an increase in NLR in stroke patients( p = 0.0001). This study determined the NLR cut-off value to differentiate stroke with healthy controls. the cut-off value obtained is 1.745, based on the cut-off, a person become stroke if NLR >1.75. the cut-off value of NLR has 93.33% sensitivity, 99.4% specificity, 98.2% positive predictive value, 97.5% negative predictive value, 97.7% accuracy and under-the-curve area (AUC) of 98.7%. Comparisons between NLRs in the NIHSS mild category have a median of 3.09, NLRs
in NIHSS moderate category has a median of 3.48 and for NLRs in the NIHSS severe category has a median of 6.58,(p = 0,512; p> 0.05).
Conclusions: NLR plays a role in differentiating stroke patients and healthy controls so that it can be used as a diagnostic tool (under-the-curve area (AUC) 98.7%). and
there was no statistically significant difference between the NIHSS score category and the NLR. |