Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. This retrospective cohort study found that higher low-grade inflammation (LGI) scores were associated with significantly higher acute ischemic stroke (AIS) severity, worse early neurological deterioration (END), and poor outcomes at 90 days after stroke onset.

Evidence Rating Level: 2 (Good)

Ischemic stroke is a significant global cause of neurological morbidity and mortality. Inflammation, both systemic and local, plays a key role in its pathogenesis. There has been growing interest in using serum biomarkers to predict outcomes in AIS. The LGI score, a novel marker incorporating C-reactive protein, leukocyte counts, the neutrophil/lymphocyte ratio, and platelet count, has been successfully used to predict outcomes in various medical conditions. This retrospective cohort study evaluated 876 patients (median age [range] 70 [60.5-78], 58% male) with a diagnosis of ischemic stroke to assess the LGI score’s effectiveness in predicting functional outcomes in ischemic stroke patients. The LGI score, ranging from -16 to 16, with higher scores indicating higher intensities of low-grade inflammation. After adjusting for potential confounders (age, sex, vascular risk factors), a fourth quartile LGI score was independently associated with stroke severity (evaluated using the National Institutes of Health Stroke Scale score) at baseline (OR = 10.32, 95% CI: 5.38–19.78, p < 0.001) and at one week after stroke onset (OR = 7.59, 95% CI: 4.11–13.99, p< 0.001). In addition, the LGI score was found to be a risk factor of early neurological deterioration (END) (OR = 3.97, 95% CI: 1.57–10.06, p= 0.002) and poor outcomes on day 90 (OR = 2.65, 95% CI: 1.47–4.76, p= 0.001). The LGI score had an area under the curve (AUC) of 0.682 (95% CI = 0.64–0.72) and enhanced the AUC of the conventional model when used together. Overall, these findings suggest a strong correlation between the LGI score and AIS severity, supporting its use as a reliable predictor of unfavorable outcomes at 90 days after stroke onset in patients with AIS.

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