Prognostic Significance of Various Inflammation-Based Scores in Patients with Mechanical Thrombectomy for Acute Ischemic Stroke

Background: The objective of this study was to assess the relationship between inflammation-based scores and prognosis of patients who had undergone mechanical thrombectomy (MT) for large artery occlusion. Methods: A total of 411 patients were enrolled and inflammation-based scores, such as neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), and monocyte/high-density lipoprotein cholesterol ratio (MHR) were calculated based on laboratory data. Prognoses were evaluated with unfavorable outcome (modified Rankin Scale score of 3–6), symptomatic intracranial hemorrhage, hemorrhagic transformation of infarct, and mortality. Multivariate analyses were performed to explore the relationships of inflammation-based scores with various clinical outcomes. Results: Patients with unfavorable outcome showed higher mean NLR and MHR but lower mean LMR than those with favorable outcome (NLR, 7.32 vs. 3.78, P ≤ 0.001; MHR, 1.42 vs. 1.15, P = 0.012; LMR, 2.76 vs. 3.70, P = 0.003). In multivariate analysis, higher NLR (≥5.1) (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.04–2.12; P = 0.014) and higher MHR (≥1.4) (OR, 1.32; 95% CI, 1.10–1.74; P = 0.028), lower LMR (<2.5) (OR, 1.28; 95% CI, 1.08–1.58; P = 0.032) were independently associated with unfavorable outcome. Conclusions: After MT, higher NLR, higher MHR, and lower LMR were found in patients with unfavorable outcome. Inflammation-based scores, such as NLR, LMR, and MHR, might be independent factors that can predict outcomes in patients with MT.