Mean platelet volume/platelet count ratio as a predictor of 90-day outcome in large artery atherosclerosis stroke patients

Objective: Previous studies reported a lower platelet count (PC) level and a higher mean platelet volume (MPV) level in severe ischemic stroke. We define MPV/PC as the platelet ratio (PR). This study investigates the relationship between PR and 90-day outcome of large artery atherosclerosis (LAA) stroke. Materials and Methods: A retrospective analysis was conducted on 338 LAA patients in two hospitals by looking up the electronic medical record (EMR). The 90-day functional outcome was divided into good and poor according to the modified Rankin Scale (mRS) score. Results: Multivariate logistic regression analysis of the First Affiliated Hospital of Wenzhou Medical University (Hospital 1) revealed that PR (OR1.083, 95%CI [1.044, 1.123], P < 0.001) and National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of the poor outcome. Analysis from the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University (Hospital 2) showed that PR (OR1.071, 95%CI [1.039, 1.104], P < 0.001), NIHSS score and age were independent adverse prognostic predictors. Furthermore, higher quartiles of PR presented an incremental OR value compared to the first quartile PR in multivariate regression. In Hospital 1, the cut-off value of PR to predict 90-day outcome was 39.23 (sensitivity: 74.24%, specificity: 55.17%, area under the curve (AUC): 0.694, P < 0.001). In Hospital 2, the optimal cut-off value of PR was 46.08 (sensitivity: 61.40%, specificity: 73.74%, AUC: 0.695, P < 0.001). Conclusions: Platelet ratio on admission is an independent predictor for 90-day outcome in LAA stroke patients and it has a good predictive effect.