Association of Serum Hypoalbuminemia with Severity and Short-Term Prognosis in Acute Ischemic Stroke

Abstract

ABSTRACT:
Background: Stroke is a leading cause of disability and mortality. Serum albumin, a key indicator of nutritional and inflammatory status, has been linked to stroke severity and recovery.

Objectives: To evaluate serum albumin levels at admission in acute ischemic stroke (AIS) patients, assess stroke severity, and examine the correlation between serum albumin levels and functional outcomes.

Methods: This was a prospective cohort study conducted in the Department of General Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, India between July 2023 and December 2024.

Results: Among the 90 study participants, those with moderate to severe stroke (NIHSS ≥ 5) were significantly older, with a mean age of 60.9 years, compared to 53.8 years in those with minor stroke (p = 0.037). Gender distribution was similar between groups, and no significant differences were observed regarding smoking, alcohol consumption, hypertension, or diabetes. Similarly, those with moderate to severe disability or death (mRS ≥ 3) were older (mean: 61.8 years) than those with no significant or slight disability (mean: 53.8 years) (p = 0.013). Patients aged >60 years were more likely to have moderate to severe disability or death (55.6%) compared to those with no or slight disability (33.3%) (p = 0.025). Gender and other vascular risk factors showed no significant differences between the groups. Serum albumin levels were significantly lower in patients with moderate to severe stroke (mean: 2.8 g/dL) compared to those with minor stroke (mean: 3.8 g/dL) (p < 0.001). Similarly, lower albumin levels were associated with poor functional outcomes (p < 0.001). A significant negative correlation was found between albumin levels and both NIHSS (rp = -0.521) and mRS (rp = -0.484) scores. ROC analysis confirmed hypoalbuminemia (<3.4 g/dL) as a strong predictor of stroke severity and short-term prognosis.

Conclusion: This study highlights the strong association between hypoalbuminemia and both stroke severity and poor short-term functional outcomes. Serum albumin levels may serve as a valuable prognostic marker for assessing stroke prognosis and guiding early interventions.