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Abstract Presentation Date: 6/9/2024 Presentation Start Time: 3:00:00 PM Background Sickle cell disease (SCD) presents a formidable healthcare challenge, with stroke being a significant complication. The gold standard for stroke risk assessment is transcranial doppler ultrasound (TCD). However, resource constraints often limit TCD availability. This study explores the potential of the platelet-neutrophil ratio (PNR) as a cost-effective and an additional tool for assessing stroke risk in SCD patients. Methods This was a retrospective study conducted on 144 SCD HbSS children from Children’s National Hospital, Washington DC, USA as part of the CNH Natural History Study of SCD. TCD values were categorized (based on the STOP Study) as normal, abnormal, or conditional. PNR was calculated from routine complete blood count tests. Statistical analyses were employed to evaluate the association between the platelet-neutrophil ratio and stroke risk. Results The platelet-neutrophil ratio (PNR) demonstrated distinctive values across stroke risk categories: 83.83 (58.15-127.65) for normal, 75.69 (64.89-88.6) for conditional, and 62.57 (28.12-64.47) for abnormal (p = 0.031). Following adjustments for age and hydroxyurea intake, a unit increase in PNR was significantly associated with a decreased risk of stroke (OR = 0.975, 95% CI: 0.953-0.998, p = 0.0345). PNR showed superior discriminative performance for stroke risk compared to neutrophils and platelets, with AUC values of 0.81, 0.57, and 0.19, respectively. Conclusions This research unveils a promising avenue for more equitable healthcare in SCD management by introducing the platelet-neutrophil ratio (PNR) as a cost-effective and additional tool to assess for stroke risk in poor resource settings. A larger study is needed to validate these findings.
Efobi et al. (Sat,) studied this question.