Inflammatory markers and functional outcome score in different subgroups of ischaemic stroke: a prospective cohort study

BACKGROUND: Acute ischaemic stroke (AIS) is a leading cause of disability and mortality worldwide.

Determining subgroups and outcomes of AIS may lead to better treatment.

We aimed to investigate the relationship between inflammatory markers and subgroups of AIS with further follow-up of patients in terms of functional outcome score.

METHODS: In this prospective cohort study, we examined white cell count (WCC), neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR) and qualitative C reactive protein (CRP), in the first 24 hours of patients’ admission.

Patients were assigned to AIS subgroups as defined by the TOAST criteria.

Then patients’ disability score was followed up after 3 and 6 months, using the modified Rankin Scale.

RESULTS: We included 217 patients with AIS.

The mean age of participants was 72.07 years, and we included 92 women (42.4%).

For the AIS subgroup, 83 (38.25%) patients had large artery atherosclerosis (LAA), 41 (18.89%) had cardioembolism and 62 (28.57) had small vessel obstruction.

Neutrophil count and NLR showed a statistically significant difference in the subgroups of AIS and were highest in the ‘other’ subgroup of AIS (p<0.05).

Lymphocyte count, ESR and qualitative CRP showed no statistically significant difference between subgroups (p>0.05).

WCC, neutrophil count and NLR showed a positive correlation with functional outcomes (p<0.05), other markers did not correlate with outcomes (pp>0.05).

CONCLUSION: We can conclude that neutrophil count and NLR are available inflammatory biomarkers for predicting outcomes and these two biomarkers are associated with AIS subgroups.

However, ESR, qualitative CRP and lymphocyte count do not appear to be correlated with outcomes or subgroup of AIS.