Analysis of Neutrophil/Lymphocyte ratio and Thiol/Disulfide homeostasis parameters in patients admitted to the emergency department with ischemic stroke

Objectives: It is known that the neutrophil/lymphocyte ratio (NLR) is associated with adverse outcomes in ischemic stroke patients. We aimed to reveal the association of NLR and thiol/disulfide homeostasis (TDH) with ischemic stroke patients.

Methods: This study was conducted prospectively at tertiary hospital in emergency department between March 18, 2017 and November 30, 2017. It included 143 patients who were diagnosed with stroke, exhibited no hemorrhage on the Computed Tomography (CT) of the head were included in the study. Complete blood count, biochemical, TDH parameters and Ischemia Modified Albumin (IMA) were studied.

Results: Neutrophil count and NLR were significantly higher in the patient group (p<0.001, p=0.001, respectively). The mean Native Thiol (NT) value of the patient group was 359.9 ± 84.59 μmol/L. The mean Total Thiol (TT) value in the patient group was 399.38 ± 86.06 μmol/L. The NT and TT values in the patient group were significantly lower (NT/TT: p = 0.002/p = 0.007), whereas NLR and IMA were significantly higher in the patient group (p = 0.001/p < 0.001).

Conclusions: Physicians should focus on patients with increased NLR, as these patients appear to represent a population at risk for increased morbidity. We have quantitatively demonstrated in tissue oxidative stress level with TDH parameters. Investigation of these new parameters should be continued for the determination of prognostic significance.