Clinical significance of albumin/globulin ratio for survival prediction in ischemic stroke patients in intensive care

Objective: Decreased level of serum albumin is shown to be associated with an increased risk of mortality after stroke. However, the significance of the albumin/globulin ratio (AGR) as a paraclinical marker in determination of the prognosis of stroke is unclear. In this study, we aimed to examine the potential utility of AGR in determination of the need of intensive care unit monitorization and prognosis of patients with acute stroke. Material and Methods: Sequential samples of all the patients with acute ischemic stroke (AIS) who were hospitalized between 2018 and 2022 in the mentioned centers were analyzed in this research. The data regarding the demographic features, stroke subtypes, and laboratory findings including hemogram, and biochemistry were recorded. AGR, serum osmolality, and colloid osmotic pressure (COP) were also measured. The survival curves of the patients were constructed using the Kaplan-Meier methods and log-rank tests. Estimates of survival changes were made by applying the Cox regression analysis. Results: Ultimately, the data of 328 patients were analyzed. Thirty nine (30.2%) had passed away before discharge. There were significant differences between the deceased patients and patients surviving in terms of stroke classification, serum albumin, AGR, CRP, COP, and white blood cell count (p < 0.05). Serum AGR of 94 patients who were intensive care unit patients showed a statistical difference compared to albumin (p < 0.05). The Cox’s regression analyses showed that low AGR moderately predicted the mortality of patients. Conclusion: We found that the AGR provided important data regarding the necessity of critical care monitorization and prognosis of patients with AIS. Our findings support the potential utility of AGR as a simple, and useful paralinical laboratory marker in patients with AIS.