Özet:

Aim: Interest in the relationship between the diagnosis and clinical results of stroke and hematological parameters has been increasing in recent years. The effects of Lymphocyte/Monocyte Ratio (LMR), Neutrophil/Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW), which are indicators of immune response, on long-term clinical results in stroke have been investigated, but there are few studies on the effects of short-term clinical results during hospitalization has been investigated. In this study, we aimed to evaluate the changes in these hematological parameters [Lymphocyte/Monocyte Ratio (LMR), Neutrophil/Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW)] at the time of diagnosis and their relations with clinical and radiological parameters at the first admission and one week after hospitalization, retrospectively, and analyzed. Material and Methods: A total of 150 patients, 78 female (52.0%) and 72 male (48.0%), between 51-88 years old, who applied to our hospital and were diagnosed with ischemic stroke and 100 healthy controls with similar demographic characteristics were included in the study. LMR, NLR, MPV and RDW values of the patient and control groups at the time of first admission were recorded. In addition, the modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores at first admission and one week after hospitalization, and the groups to which the patients belonged according to the Bamford classification were recorded. Results: Mean LMR was 2.4±0.7 in the patients, and it was 4.1±1.4 in the control group (p<0.001). Median NLR value was 4.5 (1.6-21.3) in the patient group, and it was 2.1 (1.1-4.6) in the control group (p<0.001). Mean MPV was 9.3±1.0 fL in the patient group and 8.6±1.0 fL in the control group (p<0.001). Median RDW value was 14.2% (11.8%-22.1%) in the patient group and 13.8% (12.2%-20.2%) in the control group (p=0.015). Mean mRS value of the patients at admission was 3.7±1.2 while the mean mRS value at the end of the first week was 3.2±1.5 (p<0.001). In addition, the mean NIHSS score of the patients at admission was 8.3±4.8 while the mean NIHSS score at the end of the first week was 7.1±5.9 (p<0.001). It was observed that the mRS scores of the patients both at admission and at the end of the first week were correlated with LMR, NLR and RDW levels (values at admission were r=-0.508. p<0.001; r=0.728, p<0.001; r=0.238, p=0.003, respectively; values at the end of the first week were r=-0.432, p<0.001; r=0.718, p<0.001; r=0.225, p=0.006, respectively). It was observed that the NIHSS scores of the patients both at admission and at the end of the first week were also correlated with LMR, NLR and RDW levels (values at admission were r=-0.373, p<0.001; r=0.655, p<0.001; r=0.182, p= 0.026, respectively; values at the end of the first week were r=-0.407, p<0.001; r=0.699, p<0.001; r=0.173, p=0.035, respectively). Advanced age was associated with higher NLR and lower LMO in patients (r=0.165, p=0.044; r=-0.242, p=0.003, respectively). In addition, advanced age was correlated with mRS and NIHSS scores at admission and at the end of the first week (r=0.333, p<0.001; r=0.309, p<0.001; r=0.304, p<0.001; r=0.300, p<0.001, respectively). Conclusion: LMO, NLO, MPV and RDW values can provide important information in determining the clinical severity at the time of diagnosis of the disease and one week later.

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