Key result
Higher platelet ratio on admission independently predicted poor 90-day functional outcome in large artery atherosclerosis stroke patients (Hospital 1: OR 1.083, P<0.001; Hospital 2: OR 1.071, P<0.001).
Why the study?
Does the mean platelet volume/platelet count ratio (PR) on admission predict 90-day functional outcome in patients with large artery atherosclerosis stroke?
Observational (n=338)
Yes
Does the mean platelet volume/platelet count ratio (PR) on admission predict 90-day functional outcome in patients with large artery atherosclerosis stroke?
Odds Ratio: 1.083 (95% CI 1.044–1.123)
p-value: p=< 0.001
A higher mean platelet volume/platelet count ratio on admission is an independent predictor of poor 90-day functional outcome in patients with large artery atherosclerosis stroke.
Supports PR as a potential prognostic marker in LAA stroke; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVE: Previous studies reported a lower platelet count (PC) level and a higher mean platelet volume (MPV) level in severe ischemic stroke. We define MPV/PC as the platelet ratio (PR). This study investigates the relationship between PR and 90-day outcome of large artery atherosclerosis (LAA) stroke. MATERIALS AND METHODS: A retrospective analysis was conducted on 338 LAA patients in two hospitals by looking up the electronic medical record (EMR). The 90-day functional outcome was divided into good and poor according to the modified Rankin Scale (mRS) score. RESULTS: Multivariate logistic regression analysis of the First Affiliated Hospital of Wenzhou Medical University (Hospital 1) revealed that PR (OR1.083, 95%CI [1.044, 1.123], P < 0.001) and National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of the poor outcome. Analysis from the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University (Hospital 2) showed that PR (OR1.071, 95%CI [1.039, 1.104], P < 0.001), NIHSS score and age were independent adverse prognostic predictors. Furthermore, higher quartiles of PR presented an incremental OR value compared to the first quartile PR in multivariate regression. In Hospital 1, the cut-off value of PR to predict 90-day outcome was 39.23 (sensitivity: 74.24%, specificity: 55.17%, area under the curve (AUC): 0.694, P < 0.001). In Hospital 2, the optimal cut-off value of PR was 46.08 (sensitivity: 61.40%, specificity: 73.74%, AUC: 0.695, P < 0.001). CONCLUSIONS: Platelet ratio on admission is an independent predictor for 90-day outcome in LAA stroke patients and it has a good predictive effect.
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Quan et al. (2017) conducted an observational in Large artery atherosclerosis (LAA) stroke (n=338). Platelet ratio (MPV/PC) vs. First quartile platelet ratio was evaluated on Poor 90-day functional outcome (OR 1.083, 95% CI 1.044-1.123, p=< 0.001). Higher platelet ratio on admission independently predicted poor 90-day functional outcome in large artery atherosclerosis stroke patients (Hospital 1: OR 1.083, P<0.001; Hospital 2: OR 1.071, P<0.001).
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