Synergistic impact of immuno-nutritional and hypoxia-metabolic disturbances on post-stroke epilepsy: a “Two-Hit” prediction model and web-based risk calculator

The CAR and LAR are potent synergistic predictors of PSE, supporting a "Two-Hit" mechanism involving immuno-metabolic disturbances. The developed web-based calculator serves as a valuable preliminary screening tool to identify metabolically high-risk patients. While the model demonstrates robust internal validity, external validation is warranted before widespread clinical adoption. These findings also suggest that optimizing immuno-nutritional management may act as a novel neuroprotective strategy.