Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors
BackgroundThe neutrophil-percentage-to-albumin ratio (NPAR) functions as an integrative marker representing inflammatory response and nutritional health. However, its association with mortality in elderly stroke survivors has not been explored.MethodsThis cohort study analyzed data from 1,026 elderl...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2025.1611289/full |
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| author | Jie Huang Xiaowei Zhang Luyao Ding Jiaxiang Yu Mingshen Lin |
| author_facet | Jie Huang Xiaowei Zhang Luyao Ding Jiaxiang Yu Mingshen Lin |
| author_sort | Jie Huang |
| collection | DOAJ |
| description | BackgroundThe neutrophil-percentage-to-albumin ratio (NPAR) functions as an integrative marker representing inflammatory response and nutritional health. However, its association with mortality in elderly stroke survivors has not been explored.MethodsThis cohort study analyzed data from 1,026 elderly stroke survivors in the National Health and Nutrition Examination Survey (NHANES, 1999-2018). The association of NPAR with mortality was analyzed using Cox proportional hazards regression, restricted cubic splines (RCS), Kaplan-Meier survival analysis, and time-dependent receiver operating characteristic (ROC) curves. Subgroup analyses and interaction tests were also performed.ResultsDuring the 6.65-year median follow-up, elevated NPAR showed independent associations with increased all-cause and cardiovascular mortality. Quartile-based analysis revealed 69 and 87% greater mortality hazards for the highest versus lowest NPAR groups, respectively. RCS analysis revealed a non-linear threshold effect at NPAR = 14.5, beyond which the risk of all-cause mortality increased sharply. NPAR demonstrated stable predictive accuracy, with time-dependent AUC ranging from 0.664 to 0.607 for all-cause mortality and 0.652-0.609 for cardiovascular mortality over 3-10 years. Subgroup analyses confirmed consistency across different sex, BMI, lifestyle habits, and comorbidity categories.ConclusionThis study underscores a strong positive correlation between NPAR and prognosis in older adult stroke survivors in the United States, indicating its potential as a novel biomarker for prognostic assessment. |
| format | Article |
| id | doaj-art-5c15ede800e640e8909a404e9368a1d3 |
| institution | DOAJ |
| issn | 1663-4365 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Aging Neuroscience |
| spelling | doaj-art-5c15ede800e640e8909a404e9368a1d32025-08-20T03:12:38ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-05-011710.3389/fnagi.2025.16112891611289Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivorsJie Huang0Xiaowei Zhang1Luyao Ding2Jiaxiang Yu3Mingshen Lin4Department of Cardiology, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of Clinical Laboratory, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of Cardiology, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of Emergency Medicine, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of Clinical Laboratory, Lishui Municipal Central Hospital, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaBackgroundThe neutrophil-percentage-to-albumin ratio (NPAR) functions as an integrative marker representing inflammatory response and nutritional health. However, its association with mortality in elderly stroke survivors has not been explored.MethodsThis cohort study analyzed data from 1,026 elderly stroke survivors in the National Health and Nutrition Examination Survey (NHANES, 1999-2018). The association of NPAR with mortality was analyzed using Cox proportional hazards regression, restricted cubic splines (RCS), Kaplan-Meier survival analysis, and time-dependent receiver operating characteristic (ROC) curves. Subgroup analyses and interaction tests were also performed.ResultsDuring the 6.65-year median follow-up, elevated NPAR showed independent associations with increased all-cause and cardiovascular mortality. Quartile-based analysis revealed 69 and 87% greater mortality hazards for the highest versus lowest NPAR groups, respectively. RCS analysis revealed a non-linear threshold effect at NPAR = 14.5, beyond which the risk of all-cause mortality increased sharply. NPAR demonstrated stable predictive accuracy, with time-dependent AUC ranging from 0.664 to 0.607 for all-cause mortality and 0.652-0.609 for cardiovascular mortality over 3-10 years. Subgroup analyses confirmed consistency across different sex, BMI, lifestyle habits, and comorbidity categories.ConclusionThis study underscores a strong positive correlation between NPAR and prognosis in older adult stroke survivors in the United States, indicating its potential as a novel biomarker for prognostic assessment.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1611289/fullNPARelderlystroke survivorsmortalityNHANES |
| spellingShingle | Jie Huang Xiaowei Zhang Luyao Ding Jiaxiang Yu Mingshen Lin Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors Frontiers in Aging Neuroscience NPAR elderly stroke survivors mortality NHANES |
| title | Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors |
| title_full | Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors |
| title_fullStr | Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors |
| title_full_unstemmed | Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors |
| title_short | Association of neutrophil-percentage-to-albumin ratio with mortality in older stroke survivors |
| title_sort | association of neutrophil percentage to albumin ratio with mortality in older stroke survivors |
| topic | NPAR elderly stroke survivors mortality NHANES |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2025.1611289/full |
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