P-OT017. Neutrophil-to-lymphocyte ratio, monocyte-to- lymphocyte ratio, and platelet-tolymphocyte ratio biomarkers in severe hemorrhagic stroke patients: Which ratio to choose as a mortality predictor?

Introduction. Several biomarkers are now being developed to predict the prognosis of stroke. Ratios of the white blood’s components are widely studied as short-term and long-term prognostic factors in patients with intensive care. Stroke, particularly severe hemorrhagic stroke, is a condition that needs intensive care that has the potential to worsen anytime in its acute period and eventually leads to death. Here, we studied the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) on- admission as potential predictors of in-hospital mortality in severe hemorrhagic stroke patients. Methods. It is a retrospective observational study in severe hemorrhagic stroke with conventional treatment. We reviewed the medical records to obtain clinical and laboratory data and divided the patients into survivors vs non-survivors. The laboratory data were searched for white blood cell (WBC) count, neutrophil count, lymphocyte count, monocyte count, and platelet count. The NLR, MLR, and PLR were then manually estimated. Results. Of the 30 eligible patients, 25 patients were survivors and 5 patients were non- survivors. In the laboratory examinations, the neutrophil, lymphocyte, and monocyte counts showed a significant difference between survivors and non-survivors. Furthermore, we also found that NLR and MLR were two ratios that had significant difference statistically. Also, if we used the NLR cut-off point of 5 to separate high and low NLR, we found that NLR on- admission is associated with in-hospital mortality. Conclusion. NLR and MLR on-admission were significantly different between survivors and non-survivors of severe hemorrhagic patients that were treated conventionally. Also, NLR on- admission > 5 could be associated with in-hospital mortality.