RASIO NEUTROFIL LIMFOSIT DARAH TEPI SEBAGAI INDIKATOR OUTCOME PADA STROKE ISKEMIK AKUT

Abstract

Background: Inflammation in ischemic stroke is the leading cause of acute inflammatory conditions that threaten the penumbra in the surrounding area of necrotic cell and tissue damage from inflammation that increases the incidence of mortality and disability. The role of inflammatory markers is large enough in assessing the ischemic stroke development. Neutrophil lymphocyte ratio (NLR) is one of inflammatory markers which combines neutrophils as a component of active inflammation and lymphocyte as a regulatory and protective components in a single parameter. Rate NLR is expected to indicate the outcome stroke more carefully. Objective: To prove that NLR peripheral blood can be used as an indicator of ischemic stroke outcome. Method: The design of cohort study in patients with acute ischemic stroke who were treated at the Dr.Kariadi Hospital Semarang taken with consecutive sampling. NLR and evaluation of National Institutes Health Stroke Scale (NIHSS) score at <72 hours of the onset were performed to 31 patients having ischemic stroke attack for the first time. At day 7 evaluation of NIHSS score was repeated thoroughly. Correlation between variables were analyzed using Chi Square test, paired t test, Pearson test, ROC curve, sensitivity and sensibility test. Result: There were 31 research subjects. There is a significant correlation between the value of NLR with delta NIHSS p = 0.001 correlation coefficient is - 0.581. ROC curve analysis obtained by the cut-off-point NLR currently signed in as indicators of change in the output stroke was 5.35 (95% CI = 0.6 - 0.9). Specificity and sensitivity test results with existing respondent data obtained sensitivity 80.00 % and 72.72% of specificity. Conclusion: Examination of peripheral blood NLR on admission could be used as an indicator of stroke outcome. Keywords: NLR, Acute Ischemic Stroke, NIHSS