Comparative prognostic value of inflammatory and nutritional indices in acute ischemic stroke: a multivariable model analysis

İrem Kıraç Utku; Nazire Çelem; Serkan Demir; Ahmet Düzgün

Makale detayları

Comparative prognostic value of inflammatory and nutritional indices in acute ischemic stroke: a multivariable model analysis

Yazarlar:

İrem Kıraç Utku | Nazire Çelem | Serkan Demir | Ahmet Düzgün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Geriatri ve Gerontoloji | İç Hastalıkları

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.902-908

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358384

pISSN:

2636-8579

Anahtar kelimeler:

Özet:

 Aims: Given that acute ischemic stroke AIS is a leading cause of mortality and long-term disability, the early identification of reliable prognostic markers is essential. This study evaluates the prognostic value of composite inflammatory and nutritional indices, including the monocyte-to-high-density lipoprotein cholesterol ratio MHR, Systemic Immune-Inflammation Index SII, Prognostic Nutritional Index PNI, and Controlling Nutritional Status CONUT score, in predicting intensive care unit ICU admission and one-year mortality following AIS. Methods: This single-center retrospective cohort study included 496 patients with a confirmed diagnosis of AIS. Clinical characteristics, laboratory parameters, and outcomes were retrospectively retrieved. The prognostic significance of selected inflammatory indices MHR, SII, neutrophil-to-lymphocyte ratio NLR, monocyte-to-lymphocyte ratio MLR, and platelet-to-lymphocyte ratio PLR and nutritional indices PNI and CONUT was analyzed using univariate and multivariate logistic regression models, along with receiver operating characteristic ROC curve analysis. Results: Higher SII and CONUT scores and lower PNI values were significantly associated with both ICU admission and one-year mortality. In multivariate analysis, CONUT and MHR emerged as independent predictors of one-year mortality, while PNI, CONUT, and MHR independently predicted ICU admission. Among all indices evaluated, CONUT demonstrated the highest predictive accuracy for both outcomes. Conclusion: In patients with AIS, composite inflammatory and nutritional indices-particularly CONUT and MHR-provided valuable prognostic information. These markers, derived from routine laboratory tests, offer a practical and cost-effective method for early risk stratification and may help guide more personalized care pathways in stroke management.

 Aims: Given that acute ischemic stroke AIS is a leading cause of mortality and long-term disability, the early identification of reliable prognostic markers is essential. This study evaluates the prognostic value of composite inflammatory and nutritional indices, including the monocyte-to-high-density lipoprotein cholesterol ratio MHR, Systemic Immune-Inflammation Index SII, Prognostic Nutritional Index PNI, and Controlling Nutritional Status CONUT score, in predicting intensive care unit ICU admission and one-year mortality following AIS. Methods: This single-center retrospective cohort study included 496 patients with a confirmed diagnosis of AIS. Clinical characteristics, laboratory parameters, and outcomes were retrospectively retrieved. The prognostic significance of selected inflammatory indices MHR, SII, neutrophil-to-lymphocyte ratio NLR, monocyte-to-lymphocyte ratio MLR, and platelet-to-lymphocyte ratio PLR and nutritional indices PNI and CONUT was analyzed using univariate and multivariate logistic regression models, along with receiver operating characteristic ROC curve analysis. Results: Higher SII and CONUT scores and lower PNI values were significantly associated with both ICU admission and one-year mortality. In multivariate analysis, CONUT and MHR emerged as independent predictors of one-year mortality, while PNI, CONUT, and MHR independently predicted ICU admission. Among all indices evaluated, CONUT demonstrated the highest predictive accuracy for both outcomes. Conclusion: In patients with AIS, composite inflammatory and nutritional indices-particularly CONUT and MHR-provided valuable prognostic information. These markers, derived from routine laboratory tests, offer a practical and cost-effective method for early risk stratification and may help guide more personalized care pathways in stroke management.

 Aims: Given that acute ischemic stroke AIS is a leading cause of mortality and long-term disability, the early identification of reliable prognostic markers is essential. This study evaluates the prognostic value of composite inflammatory and nutritional indices, including the monocyte-to-high-density lipoprotein cholesterol ratio MHR, Systemic Immune-Inflammation Index SII, Prognostic Nutritional Index PNI, and Controlling Nutritional Status CONUT score, in predicting intensive care unit ICU admission and one-year mortality following AIS. Methods: This single-center retrospective cohort study included 496 patients with a confirmed diagnosis of AIS. Clinical characteristics, laboratory parameters, and outcomes were retrospectively retrieved. The prognostic significance of selected inflammatory indices MHR, SII, neutrophil-to-lymphocyte ratio NLR, monocyte-to-lymphocyte ratio MLR, and platelet-to-lymphocyte ratio PLR and nutritional indices PNI and CONUT was analyzed using univariate and multivariate logistic regression models, along with receiver operating characteristic ROC curve analysis. Results: Higher SII and CONUT scores and lower PNI values were significantly associated with both ICU admission and one-year mortality. In multivariate analysis, CONUT and MHR emerged as independent predictors of one-year mortality, while PNI, CONUT, and MHR independently predicted ICU admission. Among all indices evaluated, CONUT demonstrated the highest predictive accuracy for both outcomes. Conclusion: In patients with AIS, composite inflammatory and nutritional indices-particularly CONUT and MHR-provided valuable prognostic information. These markers, derived from routine laboratory tests, offer a practical and cost-effective method for early risk stratification and may help guide more personalized care pathways in stroke management.

 Amaç: Önemli bir mortalite ve uzun süreli özürlülük nedeni olan akut iskemik inmede Aİİ, güvenilir prognostik belirteçlerin erken dönemde saptanması büyük önem taşımaktadır. Bu çalışmada, inflamatuvar ve nütrisyonel bileşik indekslerin  monositHDL kolesterol oranı MHR, sistemik immün-inflamasyon indeksi SII, prognostik nütrisyonel indeks PNI ve beslenme durumu kontrolü skoru CONUT  Aİİ sonrası yoğun bakım YBÜ yatışı ve bir yıllık mortaliteyi öngörmedeki değeri değerlendirilmiştir. Yöntemler: Tek merkezli, retrospektif kohort olarak planlanan bu çalışmaya Aİİ tanısı almış 496 hasta dahil edilmiştir. Klinik ve laboratuvar verileri ile klinik sonuçlar hasta dosyalarından elde edilmiştir. Seçilen inflamatuvar MHR, SII, NLR, MLR, PLR ve nütrisyonel PNI, CONUT indekslerin prognostik değeri, tek değişkenliçok değişkenli lojistik regresyon ve ROC eğrisi analizleri ile değerlendirilmiştir. Bulgular: SII, PNI ve CONUT skorlarının hem YBÜ yatışı hem de bir yıllık mortalite ile anlamlı ilişkili olduğu bulunmuştur. Çok değişkenli analizde ise, MHR ile birlikte CONUT skoru bir yıllık mortalitenin bağımsız bir yordayıcısı olarak belirlenmiştir. PNI, CONUT ve MHR, YBÜ yatışını öngörmede etkili bulunmuştur. Her iki sonlanım açısından CONUT skoru en yüksek prediktif doğruluğu göstermiştir. Sonuç: Akut iskemik inme hastalarında CONUT ve MHR başta olmak üzere, bazı inflamatuvar ve nütrisyonel bileşik indeksler prognostik değer taşımaktadır. Basit laboratuvar testleri ile elde edilebilen bu belirteçler, erken dönemde etkili risk sınıflandırmasına olanak tanıyarak maliyet duyarlı sağlık sistemlerinde kişiselleştirilmiş inme yönetimi yollarını destekleyebilir.

Makale detayları

Comparative prognostic value of inflammatory and nutritional indices in acute ischemic stroke: a multivariable model analysis

Yazarlar:

İrem Kıraç Utku | Nazire Çelem | Serkan Demir | Ahmet Düzgün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Geriatri ve Gerontoloji | İç Hastalıkları

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.902-908

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358384

pISSN:

2636-8579

Acute ischemic stroke

CONUT score

prognostic model

inflammatory biomarkers

nutritional assessmentakut iskemik inme

CONUT skoru

prognostik model

inflamatuvar biyobelirteçler

nütrisyonel değerlendirme

Sayı

Makale detayları

Yazarlar: İrem Kıraç Utku | Nazire Çelem | Serkan Demir | Ahmet Düzgün

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Geriatri ve Gerontoloji | İç Hastalıkları

Dergi: Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.902-908

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001358384

pISSN: 2636-8579

Sayı

Yazarlar:

İrem Kıraç Utku | Nazire Çelem | Serkan Demir | Ahmet Düzgün

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Geriatri ve Gerontoloji | İç Hastalıkları

Dergi:

Journal of Health Sciences and Medicine Vol.8 Issue 5, pp.902-908

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358384

pISSN:

2636-8579