The Ratio Paradox in Stroke Prognosis: Abundant Evidence, Absent Utility

卒中预后中的比率悖论：证据丰富，效用缺失

Laboratory ratios such as the neutrophil-to-lymphocyte, platelet-to-lymphocyte, and stress hyperglycemia ratios have been widely studied as prognostic markers in stroke. Despite hundreds of reports and multiple meta-analyses, these indices have shown modest effect sizes and have not influenced clinical guidelines or trial design. This commentary argues that such ratios serve as surrogates of systemic physiology rather than actionable prognostic tools, highlighting the gap between statistical association and clinical translation.

中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和应激性高血糖比值等实验室指标已被广泛研究，作为中风的预后标志物。尽管有数百篇报告和多项荟萃分析，但这些指标的效应量并不显著，也未对临床指南或试验设计产生影响。本评论认为，这些比值是全身生理状态的替代指标，而非可用于临床决策的预后工具，凸显了统计学关联与临床转化之间的差距。

REF: Marquez-Romero JM. The Ratio Paradox in Stroke Prognosis: Abundant Evidence, Absent Utility. Transl Stroke Res. 2025;17(1):1. Published 2025 Nov 27. doi:10.1007/s12975-025-01391-9 PMID: 41307643