THE VALUE OF INFLAMMATORY BIOMARKERS IN PREDICTING MORTALITY OUTCOMES IN PATIENTS WITH ACUTE ISCHEMIC STROKE RECEIVING CONSERVATIVE TREATMENT
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Abstract
Objectives: To determine the prognostic value of inflammatory biomarkers in predicting 30-day mortality outcomes among patients with acute ischemic stroke receiving conservative treatment. Methods: A prospective cohort study was conducted on 130 patients diagnosed with acute ischemic stroke at Can Tho General Hospital from May 2024 to February 2026. The inflammatory biomarkers included the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6). Results: The mean age of the participants was 64.90 ± 10.95 years, 61.5% were male and the severe stroke group (NIHSS ≥ 15 points) accounted for 27.7%. The 30-day mortality rate was 24.6%. Patients with acute ischemic stroke who died within 30 days had a significantly higher median NLR of 5.40 (IQR: 3.77 - 7.14) compared with survivors, whose median NLR was 3.75 (IQR: 2.59 - 4.72) (p < 0.05). Similarly, the median CRP level in the mortality group was 9.04 mg/L (IQR: 5.09 - 10.96), and the median IL-6 level was 13.15 pg/mL (IQR: 11.42 - 15.05), both significantly higher than in the survivor group (p < 0.05). ROC analysis showed that NLR had the highest predictive value with an AUC of 0.730 (95%CI: 0.627 - 0.832). The optimal cut-off value for NLR was 5.27, yielding a sensitivity of 56.3% and a specificity of 85.7% for predicting mortality. Conclusion: Systemic inflammatory biomarkers, including NLR, CRP, and IL-6, demonstrate potential value in predicting 30-day mortality in patients with acute ischemic stroke receiving conservative treatment.
Keywords
Ischemic stroke, Systemic inflammation, Neutrophil-to-lymphocyte ratio, C-reactive protein, Interleukin-6, Prognosis for mortality
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References
2. Peter J.K, Robin L and Georgios T. Inflammation and Stroke Risk: A New Target for Prevention. Stroke. 2021; 52(8): 2697-2706.
3. Jin R, Liu L, Zhang S, et al. Role of inflammation and its mediators in acute ischemic stroke. J Cardiovasc Transl Res. 2013; 6(5):834-851.
4. Jin R, Yang G, Li G. Inflammatory mechanisms in ischemic stroke: Role of inflammatory cells. J Leukoc Biol. 2010; 87(5):779-789.
5. Bushnell C, Howard VJ, Lisabeth L, et al. 2024 guideline for the primary prevention of stroke: A guideline from the American Heart Association/American Stroke Association. Stroke. 2024; 55(12):344-424.
6. Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke. 2021; 52(7):364-467.
7. Zhao J, Li H, Wang Y, et al. Prognostic value of inflammation biomarkers for 30-day mortality in critically ill patients with stroke. Front Neurol. 2023; 14:1110347.
8. Wu Q, Chen HS. Neutrophil-to-lymphocyte ratio and its changes predict the 3-month outcome and mortality in acute ischemic stroke patients after intravenous thrombolysis. Brain Behavior. 2023; 13(9):e3162.
9. Frøyshov HM, Ihle-Hansen H, Sandset EC, et al. Elevated inflammatory markers predict mortality in long-term ischemic stroke survivors: A population-based prospective study. Aging Clin Exp Res. 2017; 29(3):379-385.
10. Shan Y, Li X, Wang J, et al. Neutrophil-to-lymphocyte ratio and five-year mortality in patients with acute ischemic stroke. Heliyon. 2024; 10(17):e37441.