Association of inflammatory markers with functional outcome after endovascular thrombectomy in anterior circulation stroke: a retrospective study.

BACKGROUND: Endovascular thrombectomy (EVT) is an effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusion in the anterior circulation. However, functional outcomes vary. Systemic inflammatory response may affect prognosis. This study aims to determine the prognostic association of inflammatory indicators for favorable outcomes in patients undergoing EVT. METHOD: In this retrospective study, 378 patients with anterior circulation large vessel occlusion stroke (LVOS) who underwent EVT were included. Patients were stratified into favorable outcome group (mRS ≤ 2) and unfavorable outcome group (mRS > 2). Clinical baseline data and laboratory blood tests were completed on admission. Imaging data were collected between 2 and 5 days after admission. Univariate and multivariate analyses were performed to evaluate the factors associated with favorable outcome. RESULT: Compared to the favorable outcome group, the unfavorable outcome group had a higher incidence of symptomatic intracranial hemorrhage (sICH) (22%) and stroke-associated pneumonia (SAP) (59%), lower successful recanalization (mTICI 2b-3: 83.7%), and poorer collateral circulation status (58.8%). Furthermore, the unfavorable outcome group exhibited significantly higher preoperative white blood cell count, neutrophil count, monocyte count, and neutrophil-to-lymphocyte ratio (NLR) (all p < 0.05), while the lymphocyte-to-monocyte ratio (LMR) and platelet distribution width (PDW) were significantly lower (all p < 0.05). The AUC for LMR was 0.578 (95% CI 0.517-0.639), with an optimal cut-off value of 2.69 (sensitivity 64.7%, specificity 48.8%). The AUC for PDW was 0.572 (95% CI 0.511-0.636), with an optimal cut-off value of 15.2% (sensitivity 78.9%, specificity 43.1%). CONCLUSION: Inflammatory indicators, particularly LMR and PDW, were associated with functional outcome after EVT in patients with anterior circulation large vessel occlusion and may provide supplementary information for risk stratification.