Evaluation of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as prognostic markers in ischemic stroke of diabetic patients: A cross-sectional analysis.

Singh, Umesh Pratap; Mishra, Dheerendra Kumar; Gangwar, Pooja; Giri, Nikhil · J Family Med Prim Care · 2025

cross_sectional · Level IV

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Abstract

Stroke remains a significant cause of morbidity and mortality worldwide, necessitating effective prognostic tools for optimal management. Inflammation plays a pivotal role in stroke pathogenesis, highlighting the importance of biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in prognostication. A descriptive cross-sectional study involving 154 diabetic stroke patients admitted to a tertiary care hospital was conducted. Demographic, clinical, and laboratory data were collected, and Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) were calculated. Patients were categorized based on their NLR and PLR levels, and associations with stroke severity, functional outcomes, and mortality were assessed. Elevated NLR and PLR were significantly associated with increased stroke severity, decreased functional independence, and higher mortality rates. Patients with adverse outcomes exhibited higher NLR and PLR levels compared to those with favorable outcomes. For example, the mean NLR was 7.88 ± 1.45 in deceased patients compared to 2.23 ± 1.45 in discharged patients (<i>P</i> < 0.0001). Metabolic parameters, particularly fasting blood sugar levels, also played a crucial role in determining stroke prognosis. The Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) emerge as valuable prognostic markers in stroke patients, providing insights into disease severity and outcomes. Incorporating these biomarkers into clinical practice has the potential to enhance risk stratification and facilitate personalized treatment approaches. Further research is warranted to validate these findings and elucidate the underlying mechanisms linking inflammation to stroke outcomes.