Objective  To evaluate predictive effect of blood tests and neutral/lymphocyte ratio (NRL) on hospitalization cost among first-ever ischemic stroke patients for providing evidences to promote effective utilization of medical resources.

  Methods  Clinical and other relevant data on 5 840 adult patients (≥ 18 years) with first-ever ischemic stroke admitted to a general hospital in Nanchang city of Jiangxi province from January 2009 through July 2017 were collected and associations of blood test values and NRL within 24 hours of the admission with hospitalization cost were analyzed.

  Results  Of all the inpatients averagely aged 65.22 ± 12.24 years, 3 351 (62.75%) were males. The median of the hospitalization cost for all the inpatients was 13 530.87 RMB yuan. Unconditional multivariate regression analysis revealed following significant independent risk factors for hospitalization cost: medical insurance (odds ratio OR = 1.368), haemoglobin A1c (HbA1c, OR = 1.082), total bilirubin (TBIL, OR = 1.027), glucose (Glu, OR = 1.068), total cholesterol (TC, OR = 1.066), creatinine (Cre, OR = 1.002), and NLR (OR = 1.488) (P < 0.05 for all). The receiver operator characteristic curve (ROC) analysis demonstrated that the border value of NLR was 3.30, which was a good predictor for hospitalization cost. The combined prediction result of NLR, HbA1c, TBIL, CHOL, Cre, and Glu was better than that of each single factor, with an area under the curve (AUC) of 0.665 (95% confidence interval: 0.650 – 0.679), indicating a good prediction effect.

  Conclusion  Glycosylated hemoglobin, total bilirubin, glucose, total cholesterol, creatinine, and neutral/lymphocyte ratio are closely related to hospitalization cost among the first-ever ischemic stroke patients and, to some extent, these blood test indicators could be adopted to predicate hospitalization cost of the inpatients.