Predictive value of serum albumin, high-density lipoprotein cholesterol, and systemic immune-inflammation index for short-term prognosis in acute cerebral infarction after intravenous recombinant tissue plasminogen activator

OBJECTIVE: To investigate the influences of serum albumin (ALB), high-density lipoprotein cholesterol (HDL-C), combined with systemic immune-inflammation index (SII), on short-term prognosis in patients with acute cerebral infarction (ACI) receiving intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA). BACKGROUND: ACI is a leading cause of disability with high recurrence rates, posing significant public health challenges. METHODS: A total of 301 patients with ACI receiving rt-PA were divided into poor (n = 103) and good (n = 198) prognosis groups based on 3-month post-discharge modified Rankin Scale (mRS) scores. Correlations of serum ALB, HDL-C, and SII with admission National Institutes of Health Stroke Scale (NIHSS) and 3-month post-discharge mRS scores, influencing factors, and predictive value were analyzed using Spearman, logistic regression, and Receiver Operating Characteristic (ROC) curve analyses. RESULTS: Serum ALB, HDL-C, and SII correlated with admission NIHSS scores and 3-month post-discharge mRS scores and were independent influencing factors for poor short-term prognosis. The areas under the curves for predicting unfavorable short-term prognosis were 0.680 (ALB), 0.633 (HDL-C), 0.705 (SII), and 0.767 (combination). The combined model had higher predictive efficacy than any single indicator. Reduced ALB and HDL-C and elevated SII were associated with an increased risk of poor short-term prognosis. CONCLUSION: ALB, HDL-C, and SII effectively predict short-term prognosis in patients with ACI after rt-PA thrombolysis, facilitating early risk stratification.