Age&Ageing: Effectiveness of NLR for predicting the occurrence of delirium in stroke patients

Delirium is an acute neuropsychiatric syndrome, usually manifested as systemic infection , hypoxia, surgery, various medications, or complications of acute stroke, especially in elderly patients
.

It is characterized by rapid onset, marked fluctuations in symptoms throughout the day, disturbances in the wake and sleep cycles, and changes in thinking, memory, and behavior

Infection is characterized by rapid onset, marked fluctuations in symptoms throughout the day, disturbances in the wake and sleep cycles, and changes in thinking, memory, and behavior

Stroke stroke incidence of delirium in patients between 12-66%, depending on the use of the diagnostic method

Immune system activation seems to be the basis for delirium in acute neurological diseases such as neuroinfection, trauma, and stroke
.

The ratio of neutrophils to lymphocytes (NLR), which is a parameter derived from different white blood cell counts, is an easily obtained marker of inflammation and oxidative stress

The ratio of

NLR is not only a marker of systemic inflammation, but also related to adverse outcomes after acute ischemic stroke

The researchers reviewed UZ Brussel's stroke database and included 514 patients with acute ischemic stroke within 24 hours of the onset of stroke between February 2009 and December 2014
.

According to the standards of the fifth edition of "DSM-MD", two raters used retrospective medical records to assess the presence of delirium

consensus

The patients were divided into two groups: those who developed delirium within the first week after the onset of stroke (n = 201; 39%) and those who did not develop delirium (n = 313; 61%)
.

Receiver operating characteristics (ROC) and multiple logistic regression analysis (MLRA) were used to determine predictors of PSD

White blood cell, neutrophil, lymphocyte count, NLR and CRP predict the diagnostic characteristics of premature delirium in stroke patients
.

White blood cell, neutrophil, lymphocyte count, NLR and CRP predict the diagnostic characteristics of premature delirium in stroke patients
.

The average age of the sample is 71 years old, and 52% of the patients are male
.

The incidence of early onset delirium was 17.

The NLR value of unconscious patients increased (6.

NLR predicts the diagnostic characteristics of delirium on admission of stroke patients
.
Using ROC to predict the optimal NLR critical value of delirium was determined to be 4.
86

NLR predicts the diagnostic characteristics of delirium on admission of stroke patients
.
Using ROC to predict the optimal NLR critical value of delirium was determined to be 4.
86

The ROC curve of the predictive model including NLR, age, NIHSS and pre-morbid cognitive dysfunction showed an area under the curve of 0.
84 (95% CI = 0.
81-0.
88)
.

The ROC curve of the predictive model including NLR, age, NIHSS and pre-morbid cognitive dysfunction showed an area under the curve of 0.
84 (95% CI = 0.
81-0.
88)
.
The ROC curve of the predictive model including NLR, age, NIHSS and pre-morbid cognitive dysfunction showed an area under the curve of 0.
84 (95% CI = 0.
81-0.
88)
.

In summary, in addition to age, stroke severity, pre-morbid mRS, and cognitive impairment, NLR is a predictor of PSD, even independent of the development of pneumonia or urinary tract infection
.

In summary, in addition to age, stroke severity, pre-morbid mRS, and cognitive impairment, NLR is a predictor of PSD, even independent of the development of pneumonia or urinary tract infection
.
In summary, in addition to age, stroke severity, pre-morbid mRS, and cognitive impairment, NLR is a predictor of PSD, even independent of the development of pneumonia or urinary tract infection
.

 

references:

Neutrophil-to-lymphocyte ratio predicts delirium after stroke, Age and Ageing, 2021;, afab133, https://doi.
org/10.
1093/ageing/afab133

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