Leukoglycemic and neutrophil/lymphocyte indices as early predictors of mortality and disability in ischemic stroke
Keywords:
hyperglycemia, ischemic stroke, leukocytes, neutrophils, mortality, riskAbstract
Introduction: systemic inflammation and hyperglycemia have been associated with a worse prognosis in ischemic stroke. The leukoglycemic index and the neutrophil-to-lymphocyte ratio are simple and accessible markers that could improve early risk stratification.
Objective: to evaluate the relationship between the leukoglycemic index and the neutrophil-to-lymphocyte ratio, measured within the first 24 hours of hospitalization, and mortality and functional disability in patients with ischemic stroke.
Methods: an analytical, cross-sectional study was conducted on 180 patients diagnosed with ischemic stroke treated at the "Captain Roberto Rodríguez Fernández" Provincial General Teaching Hospital in Morón, Ciego de Ávila, from 2023 to 2024. The following variables were analyzed: age, sex, comorbidities, plasma glucose, total white blood cell count, and neutrophil and lymphocyte differential. The outcomes were hospital mortality and functional status at discharge using the modified Rankin Scale. Mortality and disability percentages were calculated according to index categories, evaluating discriminative capacity using receiver operating characteristic curves and area under the curve. Odds ratios with 95.00 % confidence intervals were estimated.
Results: the mean age was 68.4 years (standard deviation ±11.2), and males predominated (56.70%). Hypertension and diabetes mellitus were the most frequent comorbidities. Mortality was higher in patients with a leukoglycemic index ≥2401 (85.80 %) and a neutrophil-to-lymphocyte ratio >3 (87.50%). Functional disability also increased in these groups (51.60 % and 57.10 %, respec tively). The combination of both indices improved predictive capacity compared to each marker separately.
Conclusions: the leukoglycemic index and the neutrophil-to-lymphocyte ratio are early predictors of mortality and disability in ischemic stroke. Their combined use constitutes a simple and low-cost tool for initial risk stratification.
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