Predictive Value of Globulin to Prealbumin Ratio for 3-Month Functional Outcomes in Acute Ischemic Stroke Patients

Abstract

Objective. We aimed to evaluate and compare the association between globulin to albumin ratio (GAR) and globulin to prealbumin ratio (GPR) and 3-month functional prognosis of acute ischemic stroke (AIS) patients receiving intravenous thrombolysis therapy. Methods.234 AIS patients undergoing intravenous thrombolysis were retrospectively enrolled with acute ischemic stroke from February 2016 to October 2019. Blood sample was collected within 24 h after admission. Poor outcome was defined as the modified $\text{Rankin}\text{Scale}\left(\text{mRS}\right)\ge 3$ and a favorable outcome as $\text{mRS}<3$ . Severe stroke was defined as the $\text{National}\text{Institutes}\text{of}\text{Health}\text{Stroke}\text{Scale}\left(\text{NIHSS}\right)\text{score}>10$ on admission. Student’s $t$ -test, Mann–Whitney $U$ test, Chi-square test, logistics’ regression analysis, and receiver operating characteristic (ROC) analysis were performed. Results. Patients with poor functional outcome had higher GAR and GPR levels compared with favorable functional group ( $p=0.001$ , $p<0.001$ , respectively). Severe stroke was also associated with these two increasing variables. After adjustment for confounding factors, multivariate logistic regression analysis indicated that GPR was an independent indicator predictor of AIS. Conclusions. The 24 h GPR level can predict the 3-month functional outcome in AIS patients accepting recombinant tissue plasminogen activator (r-tPA) intravenous thrombosis.