Exploring the Correlation between Neutrophil Count and Ischemic Stroke in Patients at Bolan Medical College Hospital, Quetta.
DOI:
https://doi.org/10.69980/ajpr.v28i5.809Keywords:
Adult; Inflammation; Ischemic Stroke; Leukocytes; Prognosis; Stroke Severity IndexAbstract
Ischemic is considered to be one of the greatest causes of morbidity and mortality in the world. New data indicate that neutrophil counts increase could be a contrivance to the pathophysiology and severity of acute ischemic stroke.
Material & Methods:
The study was a cross-sectional correlational study conducted at a 6 months period (23 rd January 2025 to 30th June 2025) in the department of medicine, Bolan medical complex hospital, Quetta, Baluchistan among 38 patients diagnosed with acute ischemic stroke and confirmed by neuroimaging. The extent of stroke was identified through the assistance of the National Institutes of Health Stroke Scale (NIHSS) and the functional outcome at discharge was assessed through the assistance of the Modified Rankin Scale (mRS). The data were analyzed using SPSS 24 and correlation model and regression model with statistical significance of p = 0.05.
Results:
The average age was 58.2 years of age with 60.5 percent of them being males. The neutrophil count was higher with the severity of stroke (mild: 5.8 ± 1.2 x 10 9/L; moderate: 7.6 ± 1.5 x 10 9/L; severe: 9.1 ± 1.7 x 10 9/L; p = 0.002). The number of neutrophils had a positive correlation with NIHSS (r = 0.56, p = 0.001) and mRS (r = 0.48, p = 0.003).After adjusting for confounders, the association remained significant (β = 0.39, p = 0.012).
Conclusions:
Higher neutrophil count within 24 hours of stroke onset independently predicts greater stroke severity and poorer short-term functional outcome.
References
1. Denorme F, Rustad JL, Campbell RA. Brothers in arms: platelets and neutrophils in ischemic stroke. Curr Opin Hematol. 2021; 28(5):301-7. DOI: https://doi.org/10.1097/MOH.0000000000000665
2. Denorme F, Zinkernagel AS, et al. Neutrophil extracellular traps regulate ischemic stroke brain injury. J Clin Invest. 2022; 132(10):e154225. DOI: https://doi.org/10.1172/JCI154225
3. Yang Y, He Y, Xu Y, Han W, Zhao T, Shao Y, et al. Post-stroke neutrophil count is predictive of the outcomes of large-artery atherosclerotic stroke and associated with craniocervical atherosclerosis. Sci Rep. 2023; 13:11486. DOI: https://doi.org/10.1038/s41598-023-37815-5
4. Ferro D, Matias M, Neto J, Dias R, Moreira G, Petersen N, et al. Neutrophil-to-lymphocyte ratio predicts cerebral edema and clinical worsening early after reperfusion therapy in stroke. Stroke. 2021; 52(3):859-67. DOI: https://doi.org/10.1161/STROKEAHA.120.032130
5. Zhang Y, Li L, Jia L, et al. Neutrophil counts as promising marker for predicting in-hospital mortality in aneurysmal subarachnoid hemorrhage. Stroke. 2021; 52(10):3266-75. DOI: https://doi.org/10.1161/STROKEAHA.120.034024
6. Maestrini I, Strbian D, Gautier S, Haapaniemi E, Moulin S, Sairanen T, et al. Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes. Neurology. 2015; 85(16):1408-16. DOI: https://doi.org/10.1212/WNL.0000000000002029
7. Sarejloo S, Kheradjoo H, Haghi SE, et al. Neutrophil-to-Lymphocyte Ratio and Early Neurological Deterioration in Stroke Patients: A Systematic Review and Meta-Analysis. Biomed Res Int. 2022;2022:8656864. DOI: https://doi.org/10.1155/2022/8656864
8. Jickling GC, Liu D, Stamova B, et al. Neutrophil count is related to stroke outcome following endovascular therapy. Neurology. 2019; 93(3):e274-e282. DOI: https://doi.org/10.1212/WNL.0000000000007851
9. Peña-Martínez C, Flores-Soto E, et al. Neutrophil extracellular trap targeting protects against experimental ischemic stroke. Front Immunol. 2022; 13:790002. DOI: https://doi.org/10.3389/fimmu.2022.790002
10. Bui TA, Jickling GC, Winship IR. Neutrophil dynamics and inflammaging in acute ischemic stroke: A transcriptomic review. Front Aging Neurosci. 2022; 14:1041333. DOI: https://doi.org/10.3389/fnagi.2022.1041333
11. Graça SC, Soares-da-Silva P, et al. Prognostic impact of neutrophil-to-lymphocyte ratio in acute ischemic stroke: a systematic review. J Pers Med. 2024; 14(12):1149. DOI: https://doi.org/10.3390/jpm14121149
12. Liaptsi E, Merkouris E, Polatidou E, Tsiptsios D, Gkantzios A, Kokkotis C, et al. Targeting neutrophil extracellular traps for stroke prognosis: A promising path. Neurol Int. 2023; 15(4):1212-1226. DOI: https://doi.org/10.3390/neurolint15040076
13. Pinzon RT, Veronica V. Leukocyte count and neutrophil-to-lymphocyte ratio as simple hematologic predictors of stroke severity and functional outcome in acute ischemic stroke patients. Open Neurol J. 2022; 16:e1874205X2209280. DOI: https://doi.org/10.2174/1874205X-v16-e2209280
14. Liao M, Liu Y, et al. High neutrophil counts before endovascular treatment predict worse outcomes after thrombectomy. Front Aging Neurosci. 2022; 14:978740. DOI: https://doi.org/10.3389/fnagi.2022.978740
15. Cai W, Wang J, Hu M, Chen X, Lu Z, Bellanti JA, et al. All-trans retinoic acid protects against acute ischemic stroke by modulating neutrophil functions through STAT1 signaling. J Neuroinflammation. 2019; 16:175. DOI: https://doi.org/10.1186/s12974-019-1557-6
16. Pinzon RT, et al. Leukocyte count and neutrophil-to-lymphocyte ratio as predictors of stroke severity and functional outcome. Open Neurol J. 2022; 16. DOI: https://doi.org/10.2174/1874205X-v16-e2209280
17. Zhang Z, Zhou C, Liu M, Zhang Y, Li H, He P, et al. Neutrophil counts and the risk of first stroke in general hypertensive adults. Hypertens Res. 2021;44(7):830–39. DOI: https://doi.org/10.1038/s41440-021-00625-1
18. Nowaczewska-Kuchta A, Książek-Winiarek D, Szpakowski P, Glabinski A. The role of neutrophils in multiple sclerosis and ischemic stroke. Brain Sci. 2024;14(5):423. DOI: https://doi.org/10.3390/brainsci14050423
19. Li T, Zhao J, Xie W, Yuan W, Guo J, Pang S, et al. Specific depletion of resident microglia in the early stage of stroke reduces cerebral ischemic damage. J Neuroinflammation. 2021;18:81. DOI: https://doi.org/10.1186/s12974-021-02127-w
20. Graça SC, Mosca T, Gagliardi VDB, Forte WCN, Gagliardi RJ. Prognostic impact of neutrophil-to-lymphocyte ratio in ischemic stroke. J Pers Med. 2024;14(12):1149. DOI: https://doi.org/10.3390/jpm14121149
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