Neutrophil-to-Lymphocyte ratio does not predict urinary tract infection in acute ischemic stroke

Background and purpose: neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and has been associated to both pneumonia and poor outcome after acute ischemic stroke. We aimed to determine whether NLR is a predictor of post-stroke urinary tract infection. Methods: we reviewed the stroke database and included 505 patients with acute ischemic stroke who had routine blood sampling within 24h from stroke onset. We retrieved clinical and laboratory measures (C-reactive protein (CRP), absolute neutrophil count (ANC) and absolute lymphocyte count (ALC)). NLR was defined as ANC/ALC. Patients were divided into two groups: those who developed urinary tract infection within the first week after onset (n=114) and those who didn’t (n=391). Logistic regression analysis was used to identify predictors of post-stroke urinary tract infection. Results: multiple logistic regression analysis showed that female gender (OR 3.96; 95% CI 2.83-6.87), age (OR 1.04; 95% CI 1.02-1.07) and baseline stroke severity (NIHSS) (OR 1.04; 95 % CI 1.00-1.08) but not NLR predict post-stroke urinary tract infection. ROC curve of a prediction model including age > 75, female gender and NIHSS > 7 showed an area under the curve of 0.772 (0.728-0.817). Conclusion: female gender, age and baseline stroke severity, but not NLR are predictors of post-stroke urine tract infection.