Abstract
Background: Stroke is a major cause of mortality and long-term disability worldwide. Early identification of patients at high risk of adverse outcomes remains a clinical challenge. Inflammation and thrombosis play central roles in stroke pathophysiology. The platelet-to-lymphocyte ratio (PLR), an inexpensive inflammatory marker derived from routine blood counts, has emerged as a potential prognostic biomarker in cerebrovascular diseases.
Objective: To evaluate the association between platelet-to-lymphocyte ratio and short-term mortality in patients admitted with acute stroke.
Methods: This prospective observational study was conducted among patients diagnosed with stroke and admitted to a tertiary care hospital. Platelet and lymphocyte counts obtained at admission were used to calculate PLR. Clinical severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcomes were evaluated using the Modified Rankin Scale (mRS). Patients were followed for 30 days to assess short-term mortality. Statistical analysis was performed to determine the association between PLR, clinical severity and mortality outcomes.
Results: Higher PLR values at admission were significantly associated with increased short-term mortality. Elevated PLR showed a positive correlation with higher NIHSS scores and poorer functional outcomes as measured by mRS. Patients with elevated PLR demonstrated a higher risk of mortality within 30 days compared to those with lower PLR values.
Conclusion: Platelet-to-lymphocyte ratio is a simple, cost-effective and readily available biomarker that is significantly associated with short-term mortality in stroke patients. Incorporation of PLR alongside established clinical scales such as NIHSS and mRS may improve early risk stratification and prognostic assessment, particularly in resource-limited settings.