Applicability of the low-grade inflammation score in predicting 90-day functional outcomes after acute ischemic stroke

Abstract

Abstract Background and Purpose: The low-grade inflammation (LGI) score, a novel indicator of chronic LGI, combines C-reactive protein (CRP), leukocyte counts, the neutrophil/lymphocyte ratio (NLR), and the platelet (PLT) count,to predict outcomes of patients with various conditions, such as cardiovascular diseases, cancers, and neurodegenerative diseases. However, few studies have examined the role of the LGI score in predicting functional outcomes of patients with ischemic stroke. Therefore, the present study was set to explore the potential of applying the LGI score at admission to predict outcomes of patients with ischemic stroke. Methods: A total of 1,215 patients were screened in the present study, and 876 patients were finally included based on the inclusion and exclusion criteria.Blood tests were carried out within 24 hours of admission. Severity of ischemic stroke was assessed using the NIHSS score with severe stroke denoted by NIHSS > 5. Early neurological deterioration (END) was defined as an increment in the total NIHSS score of ≥ 2 points within 7 days after admission. Patient outcomes were assessed at 90-days after stroke onset using the modified Rankin Scale (mRS). Results: The LGI score was positively correlated with baseline and one-week NIHSS scores(R2 = 0.119, p < 0.001;R2 = 0.123, p < 0.001). Multivariate regression analysis showed that the LGI score was an independent predictor of stroke severity and END. In crude model, the LGI score in the fourth quartile was associated with a higher risk of poor outcomes at 90-day compared with the LGI score in the first quartile (OR= 5.02, 95% CI: 3.09-8.14, p for trend<0.001). After adjusting for potential confounders, the LGI score in the fourth quartile was independently associated with poor outcomes at 90-day (OR=2.65, 95% CI: 1.47-4.76, p for trend=0.001). Finally, the ROC curve analysis showed an AUC of 0.682 for poor outcomes at 90- day after stroke onset. Conclusion: The LGI score is strongly correlated with the severity of acute ischemic stroke and that the LGI score is a good predictor of adverse outcomes in patients with acute ischemic stroke.