Inflammatory marker profiles and in‐hospital neurological deterioration in patients with acute minor ischemic stroke

Abstract

AbstractAimThe aim of the study was to analyze the association between inflammatory marker profiles and in‐hospital neurological deterioration (ND) in acute ischemic stroke (AIS) patients.MethodsData from patients with minor AIS from the Third China National Stroke Registry were analyzed. Inflammatory cytokine levels within 24 h of admission were measured. The primary outcome was in‐hospital ND (an increase in National Institutes of Health Stroke Scale score ≥4 from admission to discharge). Associations were evaluated using odds ratios (ORs) and 95% confidence intervals (CIs) derived from logistic regression models. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to evaluate incremental predictive values.ResultsA total of 4031 patients (1246 women, 30.9%) with a median age of 62 years were included. In‐hospital ND occurred in 121 patients (3%). Each standard‐deviation increase in interleukin (IL)‐6 (OR, 1.17 [95% CI, 1.06–1.31]) and high‐sensitivity C‐reactive protein (hsCRP) (OR, 1.43 [95% CI, 1.24–1.66]) levels was associated with increased in‐hospital ND risk. Incremental predictive values for adding IL‐6 (IDI, 0.012; NRI, 0.329) but not hsCRP levels to the conventional risk factors were found.ConclusionIn minor AIS, hsCRP and IL‐6 levels were associated with in‐hospital ND, including IL‐6 levels in prognostic models improved risk classification.