Correlations of serum prealbumin and albumin with the short-term outcomes in patients with acute ischemic stroke in different age groups

Objective To investigate the correlations of serum prealbumin and albumin with the short-term outcome in patients with acute cerebral infarction in different age groups. Methods Patients with acute ischemic stroke admitted to hospital with 48 h were prospectively enrolled in the study. The modified Rankin Scale was used to assess the functional outcomes at 14 d after onset, 0-2 was defined as a good outcome. According to the age of the patients, they were divided into either a young and middle-aged group (<60 years) or an elderly group (≥60 years). The demography, baseline clinical data and laboratory findings of the patients were compared in the overall patients and the different age groups between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of short-term outcomes. Results A total of 622 patients with acute ischemic stroke were enrolled, including 402 (64.6%) males and 220 (35.4%) females; 206 (33.1%) were in the young and middle-aged group, and 416 (66.9%) were in the elderly group; 310 (49.8%) had good outcomes and 312 (50.2%) had poor outcomes. There were significant differences in the proportions of patients in male, old people, hyperlipidemia, diabetes mellitus, history of previous stroke or transient ischemic attack (TIA), as well as age, body mass index, levels of prealbumin, albumin, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total bilirubin, direct bilirubin, indirect bilirubin, urea nitrogen, and uric acid between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that the female (odds ratio [OR] 1.522, 95% confidence interval [CI] 1.023-2.266; P=0.038), diabetes (OR 1.789, 95% CI 1.171-2.735; P=0.007) and higher low-density lipoprotein cholesterol (OR 1.251, 95% CI 1.017-1.539; P=0.034), total bilirubin (OR 1.054, 95% CI 1.029-1.081; P<0.001), urea nitrogen (OR 1.245, 95% CI 1.100-1.409; P=0.001), and baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 2.854, 95% CI 1.027-3.628; P=0.019) were the independent risk factors for poor outcomes, and higher prealbumin (OR 0.798 95% CI 0.633-0.979; P=0.034) and albumin (OR 0.741, 95% CI 0.693-0.988; P=0.020) were the independent predictors of good outcomes. In the young and middle-aged patients, there were significant differences in the proportions of patients with small artery occlusion as well as age, triglyceride, and high-density lipoprotein cholesterol levels between the good outcome group and the poor outcome group (all P<0.05); multivariate logistic regression analysis showed that diabetes (OR 2.343 95% CI 1.127-4.871; P=0.023) and higher baseline NIHSS scores (OR 2.041, 95% CI 1.304-4.125; P=0.027) were the independent risk factors for poor outcome, and higher high-density lipoprotein cholesterol (OR 0.742 95% CI 0.639-0.937; P=0.044) was an independent predictor for good outcome. In the elderly patients, there were significant differences in the proportions of patients in male, previous stroke or TIA, and cardiogenic embolism, as well as prealbumin, low-density lipoprotein cholesterol, total bilirubin, direct bilirubin, indirect bilirubin, and uric acid levels between the good outcome group and the poor outcome group (all P<0.05); multivariate logistic regression the analysis showed that diabetes (OR 2.797, 95% CI 1.153-4.756; P=0.039), higher baseline NIHSS score (OR 2.586, 95% CI 1.033-3.435; P=0.035) and higher low-density lipoprotein cholesterol (OR 1.304, 95% CI 1.027-1.656; P=0.029) were the independent risk factors for poor outcome, and higher prealbumin was an independent predictor for good outcome (OR 0.795, 95% CI 0.691-0.998; P=0.002). Conclusions Prealbumin and albumin are the independent predictors for short-term good outcome in patients with acute ischemic stroke. The protective effect of serum prealbumin is more obvious in the elderly population (≥60 years). Key words: Stroke; Brain Ischemia; Prealbumin; Serum Albumin; Biomarkers; Age Groups; Treatment Outcome