Title:Neutrophil-to-albumin Ratio as a Prognostic Factor in Patients with Acute Ischemic Stroke
Volume: 21
Issue: 3
Author(s): Jiajia Bao, Yang Zhang, Mengmeng Ma, Jian Wang, Xin Jiang, Jian Guo*Li He*
Affiliation:
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
Keywords:
Neutrophil-to-albumin ratio, NAR, inflammatory biomarker, AIS, prognosis, receiver operating characteristic, serum biomarker.
Abstract:
Background: Neutrophil-To-Albumin Ratio (NAR) is a novel inflammatory biomarker.
However, the potential prognostic value of NAR in acute ischemic stroke (AIS) remains unclear.
This study aimed to evaluate whether NAR levels correlated with the 3-month modified
Rankin scale (mRS) in patients with AIS.
Methods: AIS patients were included in this retrospective study. NAR was calculated as the ratio
of absolute neutrophil count to serum albumin level. Logistic regression analyses were used to investigate
the effect of NAR on 3-month mRS of AIS. The predictive values of NAR, albumin level,
and neutrophil count were compared utilizing receiver operating characteristic (ROC) curves.
Moreover, subgroup analyses and interaction tests were conducted to evaluate the consistency of
NAR’s effect on AIS prognosis.
Results: Of the 780 patients included, 403 (51.67%) had a poor clinical outcome (mRS 3-6) at 3
months. NAR was independently correlated to 3-month poor functional outcome after adjusting
for confounders (Odds ratios (OR), 9.34; 95% confidence intervals (CI), 1.09 to 80.13; p
=0.0417). Subgroup analysis showed a relative effect consistent with the overall population results,
and no statistical interactions were found in the subgroups (all p for interaction > 0.05). The
ROC curve showed that the prognosis-related cutoff value for NAR was 0.123, with corresponding
specificity and sensitivity of 53.55% and 63.94%, respectively. When comparing the predictive
power, NAR (0.590; 95%CI 0.549–0.630) exhibited the highest area under the curve (AUC)
of ROC compared to neutrophils (0.584; 95%CI 0.543–0.624) and albumin (0.540; 95%CI
0.500–0.581).
Conclusion: There is a positive relationship between NAR levels and 3-month poor functional outcomes
in AIS patients, supporting the potential of NAR as a readily available and economic serum
biomarker for the early identification of AIS prognosis. Further studies are required to validate the
prognostic value and clinical utility of the NAR.
