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The neutrophil-to-lymphocyte ratio is associated with functional outcome among single small subcortical infarction: Mediating effects of white matter hyperintensities

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机构： [1]Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China [2]Evidence-Based Medicine Center, Xuanwu Hospital, Capital Medical University, Beijing, China. [3]Department of Neurology, First Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China. [4]Department of Neurology, Puyang Oilfield General Hospital, Puyang, Henan Province, China. [5]Department of Neurology, Songyuan Jilin Oilfield Hospital, Songyuan, Jilin Province, China. [6]Department of Neurology, Zunhua People' Hospital, Zunhua, Hebei Province, China. [7]Department of Neurology, Puyang People's Hospital, Puyang, Henan Province, China. [8]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. [9]Beijing Municipal Geriatric Medical Research Center, Beijing, China.

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关键词： Single small subcortical infarction Neutrophil lymphocyte ratio White matter hyperintensities Functional outcome

摘要：

Increasing evidence indicated that neutrophil-to-lymphocyte ratio (NLR) was correlated with unfavorable functional outcome in ischemic stroke. However, limited studies have explored the relationship between NLR and single small subcortical infarction (SSSI). This study aims to investigate the link between NLR and functional outcome in patients with SSSI and assess whether white matter hyperintensities (WMH) mediates the relationship between NLR and unfavorable functional prognosis.This research analyzed data from patients with SSSI in a Chinese cohort study. The primary outcome was unfavorable functional outcome (modified Rankin Scale score of 2-6) at 90 days after ischemic stroke onset, and the secondary outcome was unfavorable functional outcome at discharge. The relationship between NLR and functional outcome was analyzed using restricted cubic spline (RCS) and multivariable logistic regression. A mediation analysis was conducted to examine the link between NLR and unfavorable functional outcome mediated by WMH.Among the 513 patients with SSSI included in the study, unfavorable functional outcome was seen in 145 (28.3 %) patients at the 90-day follow-up and 156 patients (30.4 %) at discharge. After controlling for confounding variables, elevated NLR levels were found to be linked with unfavorable functional outcome both at 90 days and at discharge. Mediation analyses indicated that overall WMH significantly mediated the relationship between NLR and unfavorable functional outcome at 90 days and discharge, with mediation proportions of 29.6 % and 24.2 %, respectively. Periventricular WMH accounted for 36.4 % and 32.1 % of the mediation effects, respectively.Elevated NLR independently increased the risk of unfavorable functional outcome in individuals with SSSI. In patients with SSSI, WMH partially mediated the relationship between NLR and unfavorable functional outcome.Copyright © 2025. Published by Elsevier Inc.

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出版当年[2025]版：

大类 | 4 区医学

小类 | 4 区神经科学 4 区外周血管病

最新[2025]版：

大类 | 4 区医学

小类 | 4 区神经科学 4 区外周血管病

第一作者：

第一作者机构： [1]Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China [2]Evidence-Based Medicine Center, Xuanwu Hospital, Capital Medical University, Beijing, China.

通讯作者：

通讯机构： [1]Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China [9]Beijing Municipal Geriatric Medical Research Center, Beijing, China.

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The neutrophil-to-lymphocyte ratio is associated with functional outcome among single small subcortical infarction: Mediating effects of white matter hyperintensities

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