Which one predicts mortality better in acute ischemic stroke: negative vs positive acute-phase reactants

Area of Science:

• Biochemistry
• Clinical Medicine
• Emergency Medicine

Background:

• Acute ischemic stroke (AIS) poses a significant mortality risk.
• Acute-phase reactants (APRs) are biomarkers of inflammation and tissue injury.
• The prognostic value of negative APRs in AIS patients requires further investigation.

Purpose of the Study:

• To investigate the association between negative and positive acute-phase reactants and in-hospital mortality in emergency department (ED) patients with AIS.
• To identify specific APRs that serve as independent predictors of mortality in AIS.

Main Methods:

• A cohort of 588 adult patients with AIS admitted to a tertiary hospital ED was analyzed.
• Demographic, clinical, laboratory parameters, and APRs were recorded.
• In-hospital mortality was assessed, and predictive values of APRs were determined using area under the curve (AUC) analysis.

Main Results:

• The in-hospital mortality rate among AIS patients was 17.7%.
• Albumin demonstrated the highest predictive power for mortality (AUC: 0.759, p < 0.001).
• Lower levels of albumin and transferrin (TF), both negative APRs, were identified as independent predictors of mortality (p < 0.001 and p = 0.049, respectively).

Conclusions:

• Albumin and TF levels are significant independent determinants of in-hospital mortality in AIS patients presenting to the ED.
• Decreased albumin and TF levels at ED admission are associated with an increased risk of mortality in AIS patients.
• These findings highlight the prognostic utility of negative APRs in managing AIS.