Predictive value of dynamic changes in inflammatory markers within 24 hours after mecha nical thrombectomy for outcome in patients with acute ischemic stroke

Background: This study analyzes the factors influencing the 90-day prognosis of acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT) and established a multidimensional risk model to predict postoperative 90-day outcomes.

Methods: A retrospective analysis of clinical data was conducted for AIS patients who underwent MT at our hospital. A total of 111 patients who met the inclusion criteria were included in the study. Based on the modified Rankin Scale (mRS) scores from follow-up records at 3 months post-surgery, the patients were divided into a good prognosis group (88 cases, 79.28%), a poor prognosis group (23 cases, 20.72%). Receiver operating characteristic (ROC) curves were plotted using MedCalc software, and area under the curve (AUC) values were calculated to establish a risk prediction model, presented in the form of a nomogram.

Results: Logistic regression analysis showed that C-reactive protein (T3) (p < 0.001), NIHSS score at admission (p = 0.001), and a history of atrial fibrillation (p = 0.004) were independent predictors of poor prognosis, while albumin (T2) (p = 0.008) was a protective factor for the 90-day outcome. The AUC values for these factors were 0.812, 0.760, 0.655, and 0.757, respectively. The AUC values of Normotu was 0.945. Calibration slope = 0.856, Calibration-in-the-Large ≈ 0, and Observed/Expected (O/E) ratio ≈ 1.

Conclusion: Post-MT CRP levels, NIHSS score at admission, and a history of atrial fibrillation are significantly associated with poor prognosis in these patients. Moreover, higher levels of endogenous albumin are a protective factor for the 3-month prognosis of AIS patients after MT.