{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:34:17Z","timestamp":1775032457464,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether the neutrophil-to-albumin ratio (NPAR) predicts adverse outcomes in acute large vessel occlusion (LVO) stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study enrolled 893 LVO stroke patients (2021\u20132023). Associations between NPAR and outcomes were assessed using logistic regression, restricted cubic spline, and ROC analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher NPAR correlated with elevated NIHSS, inflammatory markers, coagulation parameters, and dysphagia, and decreased hemoglobin, lymphocytes, and GCS. NPAR was an independent predictor for 90-day poor functional outcome (OR\u202f=\u202f1.10, 95%CI: 1.07\u20131.14), pneumonia (OR\u202f=\u202f1.14, 95%CI: 1.10\u20131.18), and intracerebral hemorrhage (ICH) (OR\u202f=\u202f1.06, 95%CI:1.03\u20131.10). After multivariable adjustment, associations remained robust (aOR: 1.06\u20131.14). Linear dose\u2013response relationships were observed. NPAR showed modest predictive performance (AUC: 0.60\u20130.65). Adding NPAR significantly improved pneumonia prediction over AIS-APS (AUC: 0.684\u202f\u2192\u202f0.709,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.0049), enhanced ICH sensitivity (56.6%\u202f\u2192\u202f64.6%), but minimally improved 90-day outcome prediction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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\u2019s limitations, including its single-center retrospective design, single time-point NPAR measurement, and predominantly Han Chinese population, which may limit generalizability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1753227","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:41:40Z","timestamp":1775022100000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High neutrophil-to-albumin ratio signals severe prognosis in LVO stroke\u2014data from an EICU cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Chao","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiyao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinghe","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongpo","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1177\/17474930241308142","article-title":"World stroke organization: global stroke fact sheet 2025","volume":"20","author":"Feigin","year":"2025","journal-title":"Int J Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart disease and stroke statistics-2023 update: a report from the American Heart 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