PD432 - PREDICTIVE VALUE OF THE ALKALINE PHOSPHATASE-TO-ALBUMIN RATIO FOR ALL-CAUSE DEATH AMONG CHINESE IN-HOSPITAL PATIENTS WITH ACUTE STROKE: A 12-MONTH FOLLOW-UP STUDY.

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PD432

PREDICTIVE VALUE OF THE ALKALINE PHOSPHATASE-TO-ALBUMIN RATIO FOR ALL-CAUSE DEATH AMONG CHINESE IN-HOSPITAL PATIENTS WITH ACUTE STROKE: A 12-MONTH FOLLOW-UP STUDY.

Z.-J. Liao1, G.-Q. Huang2, X.-R. Huang3, C.-W. Liao1, Z.-P. Liu1, X.-D. Zhou4, S.-L. Ye1, H.-M. Chen1, Q.-L. Lin5, R.-Q. Feng1, Y.-Z. Wu1, L.-Q. Sun6, M.-M. Zhang7, Z.-M. Cai1, W.-J. Sun8, X. Sheng8,*, B.-L. Zhu7

1The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, 2School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China c Department of Neurology, Pingyang People’s Hospital, 3Department of Neurology, Ruian People's Hospital, 4Department of Neurology, Pingyang People’s Hospital, 5Department of Neurology, Yongjia People's Hospital, 6Department of Neurology, Wenzhou Medical University Affiliated Yueqing Hospital, 7Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, 8The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

 

Rationale: Alkaline phosphatase and albumin are biomarkers of systemic inflammation , nutritional status, and vascular function. The correlation between the alkaline phosphatase to albumin ratio (AAR) and prognosis has been reported in coronary artery disease and various types of tumors. However, the association between AAR and stroke prognosis remains unclear. The purpose of this article is to investigate the association of AAR with all-cause death and poor prognosis in acute stroke.

Methods: In this prospective study, we consecutively enrolled 971 patients diagnosed with acute stroke who had their alkaline phosphatase and albumin levels measured within 48 hours of admission and were followed up for 12 months after discharge. The primary clinical outcomes were 12-month all-cause death and 12-month poor prognosis (defined as an mRS score between 3-6), while the secondary outcome was functional impairment at discharge (defined as ADL ≤60) or stroke severity (defined as an NIHSS score>4).

Results: Patients with an AAR≥2.36 had a higher risk of all-cause death (adjusted OR 2.01, 95% CI 1.18-3.54) and poor prognosis (adjusted OR 1.52, 95% CI 1.05-2.18). Additionally, patients with an AAR≥2.36 had a higher risk of functional impairment (adjusted OR 1.73, 95% CI 1.22-2.44). Subgroup analysis revealed that the high AAR group showed higher all-cause death and poorer prognosis at 12 months in the following subgroups: men, age ≥65 years. 

Conclusion: The alkaline phosphatase to albumin ratio (AAR) is an independent predictor of short- and long-term prognosis in acute stroke. It demonstrates better predictive value in men and the elderly population. 

Disclosure of Interest: None declared