TY - JOUR
T1 - The neutrophil-to-lymphocyte ratio as a prognostic biomarker in Guillain-Barre syndrome
T2 - a systematic review with meta-analysis
AU - Cabanillas-Lazo, Miguel
AU - Quispe-Vicuña, Carlos
AU - Cruzalegui-Bazán, Claudia
AU - Pascual-Guevara, Milagros
AU - Mori-Quispe, Nicanor
AU - Alva-Diaz, Carlos
N1 - Publisher Copyright:
Copyright © 2023 Cabanillas-Lazo, Quispe-Vicuña, Cruzalegui-Bazán, Pascual-Guevara, Mori-Quispe and Alva-Diaz.
PY - 2023
Y1 - 2023
N2 - Background and objectives: Guillain-Barre syndrome (GBS) is an immune-mediated neuropathy. This has raised the possibility that the neutrophil-lymphocyte ratio (NLR) may be a biomarker of its activity. We conducted a systematic review and meta-analysis to summarize the evidence of NLR as a potential biomarker for GBS. Methods: We systematically searched databases (PubMed, Ovid-Medline, Embase, Scopus, Web of Science, SciELO Citation Index, LILACS, and Google Scholar) until October 2021 for studies evaluating pre-treatment NLR values in GBS patients. A meta-analysis using a random-effects model to estimate pooled effects was realized for each outcome and a narrative synthesis when this was not possible. Subgroup and sensitivity analysis were realized. GRADE criteria were used to identify the certainty of evidence for each result. Results: Ten studies from 745 originally included were selected. Regarding GBS patients versus healthy controls, a meta-analysis of six studies (968 patients) demonstrated a significant increase in NLR values in GBS patients (MD: 1.76; 95% CI: 1.29, 2.24; I2 = 86%) with moderate certainty due to heterogeneity of GBS diagnosis criteria used. Regarding GBS prognosis, assessed by Hughes Score ≥ 3, NLR had a sensitivity between 67.3 and 81.5 and a specificity between 67.3 and 87.5 with low certainty due to imprecision, and heterogeneity. In relation to respiratory failure, NLR had a sensitivity of 86.5 and specificity of 68.2 with high and moderate certainty, respectively. Discussion: With moderate certainty, mean NLR is higher in GBS patients compared to healthy controls. Furthermore, we found that NLR could be a prognostic factor for disability and respiratory failure with low and moderate certainty, respectively. These results may prove useful for NLR in GBS patients; however, further research is needed. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021285212.
AB - Background and objectives: Guillain-Barre syndrome (GBS) is an immune-mediated neuropathy. This has raised the possibility that the neutrophil-lymphocyte ratio (NLR) may be a biomarker of its activity. We conducted a systematic review and meta-analysis to summarize the evidence of NLR as a potential biomarker for GBS. Methods: We systematically searched databases (PubMed, Ovid-Medline, Embase, Scopus, Web of Science, SciELO Citation Index, LILACS, and Google Scholar) until October 2021 for studies evaluating pre-treatment NLR values in GBS patients. A meta-analysis using a random-effects model to estimate pooled effects was realized for each outcome and a narrative synthesis when this was not possible. Subgroup and sensitivity analysis were realized. GRADE criteria were used to identify the certainty of evidence for each result. Results: Ten studies from 745 originally included were selected. Regarding GBS patients versus healthy controls, a meta-analysis of six studies (968 patients) demonstrated a significant increase in NLR values in GBS patients (MD: 1.76; 95% CI: 1.29, 2.24; I2 = 86%) with moderate certainty due to heterogeneity of GBS diagnosis criteria used. Regarding GBS prognosis, assessed by Hughes Score ≥ 3, NLR had a sensitivity between 67.3 and 81.5 and a specificity between 67.3 and 87.5 with low certainty due to imprecision, and heterogeneity. In relation to respiratory failure, NLR had a sensitivity of 86.5 and specificity of 68.2 with high and moderate certainty, respectively. Discussion: With moderate certainty, mean NLR is higher in GBS patients compared to healthy controls. Furthermore, we found that NLR could be a prognostic factor for disability and respiratory failure with low and moderate certainty, respectively. These results may prove useful for NLR in GBS patients; however, further research is needed. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021285212.
KW - Guillain-Barre syndrome
KW - NLR
KW - diagnosis
KW - neutrophil to lymphocyte ratio
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85162155348&partnerID=8YFLogxK
U2 - 10.3389/fneur.2023.1153690
DO - 10.3389/fneur.2023.1153690
M3 - Artículo de revisión
AN - SCOPUS:85162155348
SN - 1664-2295
VL - 14
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 1153690
ER -