Prognostic Value of Biochemical Inflammatory Markers for Early Functional Outcomes in Acute Ischemic Stroke: Study From a Specialized Stroke Unit

Objective: The aim os this study is to evaluate the predictive value of biochemical inflammatory markers - Platelet/Lymphocyte Ratio (PLR), Neutrophil-Lymphocyte Ratio (NLR) and C-reactive protein (CRP) – measured at admission for the short-term functional outcomes in patients with acute ischaemic stroke. Design and method: We conducted an observational study in a convenience cohort of patients admitted to a Stroke Unit between october 2025 and january 2026 for ischemic stroke who did not undergo endovascular treatment. Clinical data and laboratory results, including PLR, NLR, CPR, were collected at admission. Pulse wave velocity (PWV) was evaluated in all patients in the first 72 hours using Sphygmocor device. The primary outcome measure was a favorable outcome defined as a modified Rankin Scale (mRS) score below or equal 2 at discharge or a reduction in NIH Stroke Scale (NIHSS) at least 4 points. Results: Thirty-five patients were included (mean age 71.1 ± 10.3 years; 38.2% female). Mean PLR was 123,6±51,8, mean NLR was 2,32±1,25, and mean PCR was 6,5±10,3 mg/dL.. Mean PWV was 11.7 ± 3.52 m/s. Each 1 mg/dL increase in CRP was associated with an ∼8% reduction in the odds of achieving mRS lesser than or equal to 2 points at discharge (OR = 0.92; 95% CI: 0.82–0.99; p = 0.043), independent of sex and dyslipidemia. Similarly, each 1-unit increase in PLR was associated with an ∼2% reduction in the odds of mRS lesser than or equal to 2 points (OR = 0.98; 95% CI: 0.96–1.0; p = 0.032). No statistically significant associations were observed between PLR, NLR, or CRP and improvement in NIHSS at discharge. Conclusions: Inflammatory markers seemed to be relevant predictors of early functional outcomes in acute ischemic stroke. In our population, a lower inflammatory state was associated with better prognosis, suggesting ischemic stroke occurs on an inflammatory background. These findings support the call for preventive strategies in high-risk populations and highlight the need of larger longitudinal studies to further clarify these associations.