NGHIÊN CỨU MỐI LIÊN QUAN GIỮA NLR, SII VÀ RDW VỚI mRS TRONG NHỒI MÁU NÃO CẤP ĐƯỢC ĐIỀU TRỊ TIÊU SỢI HUYẾT TĨNH MẠCH

Abstract

Objectives: To investigate the association of NLR (neutrophil-to-lymphocyte ratio), SII (systemic immune-inflammation index), and RDW (red cell distribution width) according to the modified Rankin scale (mRS) in predicting early neurological functional outcomes in acute ischemic stroke patients treated with intravenous thrombolysis. Methods: A cross-sectional descriptive study with pre- and post-discharge follow-up was conducted on 105 patients with acute ischemic stroke who received intravenous thrombolysis at Military Hospital 103 from January 2025 to April 2026. Results: Patients with poor functional outcomes (mRS 3-6) had higher median NLR and SII values than those with good outcomes (mRS 0-2), at 3.29 vs. 2.35 and 815.59 vs. 513.00, respectively (p = 0.005). Receiver operating characteristic (ROC) analysis showed that NLR and SII predicted poor outcome with AUC values of 0.666 (cut-off: 1.89; p = 0.003) and 0.665 (cut-off: 575.1; p = 0.004), respectively. Univariate logistic regression demonstrated an increased risk of poor outcomes in patients with NLR ≥ 1.89 (OR = 5.351), SII ≥ 575.1 (OR = 4.222) and higher admission NIHSS score (OR = 1.200). In multivariate analysis, only admission NIHSS score remained an independent predictor of poor functional outcome (mRS 3-6) (OR = 1.172; p = 0.002). Conclusion: Elevated NLR and SII were associated with an increased risk of poor functional outcomes in acute ischemic stroke patients treated with intravenous thrombolysis. However, these indices were not independent prognostic factors and should be evaluated in combination with admission NIHSS.