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ORIGINAL RESEARCH article

Front. Med.
Sec. Geriatric Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1456742
This article is part of the Research Topic The Role of Inflammation in Neurodegenerative and Psychiatric Disorders View all 4 articles

The association of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-tomonocyte ratio with delirium in ischemic stroke patients

Provisionally accepted
Pangbo Wang Pangbo Wang 1*Jing Huang Jing Huang 2Liwei Xu Liwei Xu 3Rong Hu Rong Hu 1
  • 1 Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
  • 2 School of Nursing, Peking University, Beijing, China., Beijing, China., China
  • 3 Burn Plastic Surgery, NO. 946 Hospital of PLA land Force, Yining, China, Yining, Xinjiang, China

The final, formatted version of the article will be published soon.

    Background: Delirium is a severe neuropsychiatric symptom following acute ischemic stroke (IS) and is associated with poor outcomes. Systemic inflammation and immune dysregulation are thought to contribute to the pathophysiology of delirium. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are widely recognized as convenient and reliable biomarkers of systemic inflammation. However, their association with delirium after IS remains unclear.In this study, we identified IS patients requiring ICU admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database. We employed multivariable logistic regression and restricted cubic splines (RCS) to assess the association between NLR, PLR, LMR, and delirium. Twosample Mendelian randomization (MR) analysis were performed to further explore their causal relationship at the genetic level.Results: A total of 1,436 patients with IS were included in this study, of whom 214 (14.9%) had delirium.In multivariate logistic regression analysis, after adjustment for confounders, patients in the highest quartile of NLR (odds ratio [OR] 2.080, 95% confidence interval [CI], 1.282-3.375), LMR (OR 0.503, 95% CI 0.317-0.798 ) and patients in the second quartile of PLR (OR 1.574, 95% CI 1.019-2.431) were significantly associated with delirium. The RCS function showed a progressive increase in the risk of delirium with higher NLR, PLR and lower LMR. In the MR analysis, only PLR was negatively associated with the risk of delirium.Observational studies have found significant associations between NLR, PLR, LMR and delirium, but the results of MR studies do not support the causal relationship. Further prospective studies are needed to validate their association and to elucidate the underlying mechanisms.

    Keywords: Inflammation, ischemic stroke, Mendelian randomisation, risk factor, Delirium

    Received: 29 Jun 2024; Accepted: 11 Dec 2024.

    Copyright: © 2024 Wang, Huang, Xu and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Pangbo Wang, Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China

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