Lymphocyte-to-monocyte ratio and risk of hemorrhagic transformation in patients with acute ischemic stroke
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ORIGINAL ARTICLE
Lymphocyte-to-monocyte ratio and risk of hemorrhagic transformation in patients with acute ischemic stroke Quhong Song 1 & Ruosu Pan 2 & Yuxi Jin 2 & Yanan Wang 1 & Yajun Cheng 1 & Junfeng Liu 1 & Bo Wu 1 & Ming Liu 1 Received: 14 August 2019 / Accepted: 16 March 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Hemorrhagic transformation (HT) is a common complication of acute ischemic stroke (AIS), and inflammation has been found to play an important role in the occurrence of HT. We aimed to investigate the impact of lymphocyte-to-monocyte ratio (LMR), a maker of inflammatory status, on HT in patients with AIS. Methods Consecutive AIS patients within 7 days from stroke onset were enrolled between January 2016 and October 2017. LMR was calculated according to lymphocyte and monocyte counts obtained within 24 h on admission. Patients were categorized into three groups according to LMR tertiles. HT was detected by follow-up computed tomography (CT) or magnetic resonance imaging (MRI) during hospitalization. The multivariate logistic analysis was used to evaluate the independent relationship between LMR and HT. Results A total of 1005 patients were finally included. HT was observed in 99 (9.9%) patients, with 51 (5.1%) hemorrhagic infarction (HI) and 48 (4.8%) parenchymal hematoma (PH). After adjustment for potential confounders, the odds ratio (OR) of HT was 0.523 (95% confidence interval [CI] 0.293–0.936, P = 0.029) for the highest LMR tertile compared with the lowest tertile. Multiple-adjusted spline regression model showed a nonlinear approximately L-shaped relationship between LMR levels and HT (P for nonlinear trend = 0.030). There was no significant association of baseline LMR with PH (OR 0.562, 95% CI 0.249–1.268, P = 0.165). Conclusion Lower LMR was independently related to higher risk of HT in patients with AIS. Admission LMR may be used as one of the predictors for HT. Further prospective multicenter studies are needed to validate our findings. Keywords Ischemic stroke . Hemorrhagic transformation . Inflammation . Lymphocytes . Monocytes
Background Acute ischemic stroke (AIS) is a devastating disease with high morbidity and mortality that is often complicated by Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04355-z) contains supplementary material, which is available to authorized users. * Bo Wu [email protected] * Ming Liu [email protected] 1
Department of Neurology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China
2
West China School of Medicine, Sichuan University, No.17 Section 3, People’s South Road, Chengdu 610041, Sichuan Province, China
hemorrhagic transformation (HT) [1], the occurrence of which may make patient’s treatment in a dilemma [2]. Besides, HT may lead to brain damage and neurological deterioration with associated poor outcomes [3, 4]. Therefore, improved understanding of HT and identifying its key predictors are imperative to guid
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