High neutrophil-to-albumin ratio signals severe prognosis in LVO stroke—data from an EICU cohort

Objective: To investigate whether the neutrophil-to-albumin ratio (NPAR) predicts adverse outcomes in acute large vessel occlusion (LVO) stroke. Methods: This cohort study enrolled 893 LVO stroke patients (2021-2023). Associations between NPAR and outcomes were assessed using logistic regression, restricted cubic spline, and ROC analysis. Results: = 0.0049), enhanced ICH sensitivity (56.6% → 64.6%), but minimally improved 90-day outcome prediction. Conclusion: Elevated NPAR independently predicts pneumonia, ICH, and poor functional recovery in LVO stroke, serving as a potential early risk stratification tool. However, these findings should be interpreted in light of the study's limitations, including its single-center retrospective design, single time-point NPAR measurement, and predominantly Han Chinese population, which may limit generalizability.