Abstract：
BACKGROUND: Neutrophil-To-Albumin Ratio (NAR) is a novel inflammatory biomarker. However, the potential prognostic value of NAR in acute ischemic stroke (AIS) remains unclear. This study aimed to evaluate whether NAR levels correlated with the 3-month modified Rankin scale (mRS) in patients with AIS.
METHODS: AIS patients were included in this retrospective study. NAR was calculated as the ratio of absolute neutrophil count to serum albumin level. Logistic regression analyses were used to investigate the effect of NAR on 3-month mRS of AIS. The predictive values of NAR, albumin level, and neutrophil count were compared utilizing receiver operating characteristic (ROC) curves. Moreover, subgroup analyses and interaction tests were conducted to evaluate the consistency of NAR\'s effect on AIS prognosis.
RESULTS: Of the 780 patients included, 403 (51.67%) had a poor clinical outcome (mRS 3-6) at 3 months. NAR was independently correlated to 3-month poor functional outcome after adjusting for confounders (Odds ratios (OR), 9.34; 95% confidence intervals (CI), 1.09 to 80.13; p =0.0417). Subgroup analysis showed a relative effect consistent with the overall population results, and no statistical interactions were found in the subgroups (all p for interaction > 0.05). The ROC curve showed that the prognosis-related cutoff value for NAR was 0.123, with corresponding specificity and sensitivity of 53.55% and 63.94%, respectively. When comparing the predictive power, NAR (0.590; 95%CI 0.549-0.630) exhibited the highest area under the curve (AUC) of ROC compared to neutrophils (0.584; 95%CI 0.543-0.624) and albumin (0.540; 95%CI 0.500-0.581).
CONCLUSIONS: There is a positive relationship between NAR levels and 3-month poor functional outcomes in AIS patients, supporting the potential of NAR as a readily available and economic serum biomarker for the early identification of AIS prognosis. Further studies are required to validate the prognostic value and clinical utility of the NAR.
METHODS: AIS patients were included in this retrospective study. NAR was calculated as the ratio of absolute neutrophil count to serum albumin level. Logistic regression analyses were used to investigate the effect of NAR on 3-month mRS of AIS. The predictive values of NAR, albumin level, and neutrophil count were compared utilizing receiver operating characteristic (ROC) curves. Moreover, subgroup analyses and interaction tests were conducted to evaluate the consistency of NAR\'s effect on AIS prognosis.
RESULTS: Of the 780 patients included, 403 (51.67%) had a poor clinical outcome (mRS 3-6) at 3 months. NAR was independently correlated to 3-month poor functional outcome after adjusting for confounders (Odds ratios (OR), 9.34; 95% confidence intervals (CI), 1.09 to 80.13; p =0.0417). Subgroup analysis showed a relative effect consistent with the overall population results, and no statistical interactions were found in the subgroups (all p for interaction > 0.05). The ROC curve showed that the prognosis-related cutoff value for NAR was 0.123, with corresponding specificity and sensitivity of 53.55% and 63.94%, respectively. When comparing the predictive power, NAR (0.590; 95%CI 0.549-0.630) exhibited the highest area under the curve (AUC) of ROC compared to neutrophils (0.584; 95%CI 0.543-0.624) and albumin (0.540; 95%CI 0.500-0.581).
CONCLUSIONS: There is a positive relationship between NAR levels and 3-month poor functional outcomes in AIS patients, supporting the potential of NAR as a readily available and economic serum biomarker for the early identification of AIS prognosis. Further studies are required to validate the prognostic value and clinical utility of the NAR.
摘要：
背景：中性粒细胞与白蛋白比值（NAR）是一种新型的炎症生物标志物。然而,NAR在急性缺血性卒中(AIS)中的潜在预后价值尚不清楚.这项研究旨在评估NAR水平是否与AIS患者的3个月改良Rankin量表（mRS）相关。
方法：AIS患者纳入本回顾性研究。NAR计算为中性粒细胞绝对计数与血清白蛋白水平的比值。Logistic回归分析NAR对AIS3个月mRS的影响。NAR的预测值，白蛋白水平,使用受试者工作特征（ROC）曲线比较中性粒细胞计数。此外，进行亚组分析和交互作用检验,以评估NAR对AIS预后影响的一致性.
结果：在780名患者中，403（51.67％）在3个月时临床预后不良（mRS3-6）。校正混杂因素后，NAR与3个月不良功能结局独立相关(赔率(OR)，9.34；95%置信区间(CI)，1.09至80.13；p=0.0417）。亚组分析显示，相对效应与总体人群结果一致，在亚组中没有发现统计学上的相互作用(所有p为相互作用>0.05)。ROC曲线显示，NAR的预后相关临界值为0.123，相应的特异性和敏感性分别为53.55％和63.94％。分别。当比较预测能力时，与中性粒细胞（0.584;95CI0.543-0.624）和白蛋白（0.540;95CI0.500-0.581）相比，NAR（0.590;95CI0.549-0.630）表现出最高的ROC曲线下面积（AUC）。
结论：在AIS患者中，NAR水平与3个月的不良功能结局之间存在正相关，支持NAR作为一种可用于早期识别AIS预后的经济血清生物标志物的潜力。需要进一步的研究来验证NAR的预后价值和临床实用性。
方法：AIS患者纳入本回顾性研究。NAR计算为中性粒细胞绝对计数与血清白蛋白水平的比值。Logistic回归分析NAR对AIS3个月mRS的影响。NAR的预测值，白蛋白水平,使用受试者工作特征（ROC）曲线比较中性粒细胞计数。此外，进行亚组分析和交互作用检验,以评估NAR对AIS预后影响的一致性.
结果：在780名患者中，403（51.67％）在3个月时临床预后不良（mRS3-6）。校正混杂因素后，NAR与3个月不良功能结局独立相关(赔率(OR)，9.34；95%置信区间(CI)，1.09至80.13；p=0.0417）。亚组分析显示，相对效应与总体人群结果一致，在亚组中没有发现统计学上的相互作用(所有p为相互作用>0.05)。ROC曲线显示，NAR的预后相关临界值为0.123，相应的特异性和敏感性分别为53.55％和63.94％。分别。当比较预测能力时，与中性粒细胞（0.584;95CI0.543-0.624）和白蛋白（0.540;95CI0.500-0.581）相比，NAR（0.590;95CI0.549-0.630）表现出最高的ROC曲线下面积（AUC）。
结论：在AIS患者中，NAR水平与3个月的不良功能结局之间存在正相关，支持NAR作为一种可用于早期识别AIS预后的经济血清生物标志物的潜力。需要进一步的研究来验证NAR的预后价值和临床实用性。
