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The relationship among neutrophil to lymphocyte ratio, stroke territory, and 3-month mortality in patients with acute ischemic stroke



Stroke therapy options have focused on limiting the infarct volume. Neutrophil to lymphocyte ratio (NLR) can be valuable to detect the patients that required intensive treatment at early stage by predicting infarct volume. The aim of this study is to evaluate the relationship between NLR and infarct volume according to the stroke territory, and to determine the prognostic value of NLR for predicting 3-month mortality in acute ischemic stroke (AIS) patients.


A total of 107 patients with AIS were enrolled and followed up 3 months in terms of mortality. Study population was divided into two groups according to the stroke territory: anterior circulating stroke (ACS) and posterior circulating stroke (PCS). All patients underwent magnetic resonance imaging. The complete blood count and venous blood samples were obtained from the patients on admission to the emergency department.


There were no difference between ACS and PCS groups regarding baseline characteristics and co-morbid diseases. Also, C-reactive protein and NLR were similar between two groups. In correlation analyses, infarct volume was significantly correlated with CRP and NLR in ACS (r = 0.350, p = 0.001 and r = 0.482, p ≤ 0.001, respectively), but not correlated with infarct volume in PCS. Also, NLR was correlated with NIHHS in only ACS group (r = 0.326, p = 0.002). Multivariate analysis showed that NLR was the only independent predictor of 3-month mortality (OR 1.186, 95% CI 1.032–1.363, p = 0.016).


NLR is significantly correlated with ACS infarct volume, but not with PCS infarct volume in AIS. Also, NLR was an independent predictor of 3-month mortality in AIS patient.

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The authors thank the patients and their caregivers for collaboration.


The authors received no financial support for the research or authorship of this article.

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Correspondence to Feyzullah Besli.

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The study was in compliance with the Declaration of Helsinki principles and was approved by the Institutional Review Boards and Ethical Committee, and all patients involved gave their written informed consent.

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The authors declare that they have no conflict of interest.

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Kocaturk, O., Besli, F., Gungoren, F. et al. The relationship among neutrophil to lymphocyte ratio, stroke territory, and 3-month mortality in patients with acute ischemic stroke. Neurol Sci 40, 139–146 (2019).

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  • Acute ischemic stroke
  • Infarct volume
  • Stroke territory
  • Neutrophil to lymphocyte ratio
  • Mortality