Relationship between relevant inflammatory markers and short-term functional outcomes of acute ischemic stroke treated with mechanical thrombectomy: a retrospective cohort study

Background and purpose Perioperative inflammatory markers are considered critical factors influencing long-term postoperative survival. This study evaluated the neutrophil-to-high-density lipoprotein ratio (NHR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory response index (SII), and systemic inflammatory response index (SIRI) in relation to functional outcomes in patients with acute ischemic stroke who underwent mechanical thrombectomy (MT). Our objective is to determine the prognostic value of inflammatory composite indices for 90-day functional outcomes in patients with acute ischemic stroke undergoing mechanical thrombectomy and to develop a multivariable prediction model integrating these indices for individualized outcome risk stratification. Method A total of 112 patients who underwent MT were enrolled between April 2021 and December 2023. Blood tests were performed at admission. Logistic regression analysis was used to evaluate the relationship between NHR, NLR, PLR, LMR, SII, SIRI and poor functional outcomes at 3 months (mRS Score 3–6). Receiver operating characteristic (ROC) curve analysis was conducted to assess the ability of NHR, NLR, PLR, LMR, SII, and SIRI to predict 90-day functional outcomes. Results A total of 54 patients (48%) had poor functional outcomes at 3 months. The median stroke onset to admission time was 6.7 hours (IQR, 3.45–8.05) for poor functional outcome and 9.0 hours (IQR, 7.45–14.15) for good functional outcome. Mean age of the study cohort was 67.5 years, and 64.3% were male. Multivariate logistic regression analysis revealed that NHR (odds ratio OR, 1.150; 95% confidence interval CI 1.002–1.320, p = 0.046) was an independent predictor for poor functional outcome after adjusting for other clinical and imaging parameters. Conclusion NHR was independently associated with poor functional outcomes at 3 months in patients with acute ischemic stroke who underwent MT. These findings need to be confirmed in larger samples.