Why the predictive values of NLR are better than that of neutrophils
WushengZhu, Department of Neurology, Jinling Hospital, Medical School of Nanjing Universityzwsemail@sina.com
Zhiliang Guo, Shuhong Yu
Submitted October 01, 2015
We read with great interest the study by Maestrini et al. which provided evidence that higher neutrophil counts and neutrophil to lymphocyte ratio (NLR) at baseline are independently associated with symptomatic intracerebral hemorrhages (sICH) and worse outcome at 3 months. [1]
In this study, the neutrophil count was higher in patients who developed sICH, or who died within 3 months, and lower in patients with mRS 0-1 at 3 months and mRS 0-2 at 3 months. [1] Similarly, the leukocyte count was higher in patients who died at 3 months, and tended to be lower in patients with mRS 0-1 and mRS 0-2 at 3 months. However, the best predictive values for the 4 outcome measures were found with the NLR, which is the ratio of the neutrophil count over the lymphocyte count but not the product of neutrophil count and lymphocyte count.
Why might differences exist in the predictive values of neutrophil and NLR? Also, an explanation for why the predictive values of NLR are better than that of neutrophils could not be found in this study.
1. Maestrini I, Strbian D, Gautier S, et al. Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes. Neurology Epub 2015 Sep 11.
For disclosures, please contact the editorial office at journal@neurology.org.
We read with great interest the study by Maestrini et al. which provided evidence that higher neutrophil counts and neutrophil to lymphocyte ratio (NLR) at baseline are independently associated with symptomatic intracerebral hemorrhages (sICH) and worse outcome at 3 months. [1]
In this study, the neutrophil count was higher in patients who developed sICH, or who died within 3 months, and lower in patients with mRS 0-1 at 3 months and mRS 0-2 at 3 months. [1] Similarly, the leukocyte count was higher in patients who died at 3 months, and tended to be lower in patients with mRS 0-1 and mRS 0-2 at 3 months. However, the best predictive values for the 4 outcome measures were found with the NLR, which is the ratio of the neutrophil count over the lymphocyte count but not the product of neutrophil count and lymphocyte count.
Why might differences exist in the predictive values of neutrophil and NLR? Also, an explanation for why the predictive values of NLR are better than that of neutrophils could not be found in this study.
1. Maestrini I, Strbian D, Gautier S, et al. Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes. Neurology Epub 2015 Sep 11.
For disclosures, please contact the editorial office at journal@neurology.org.