Stroke-associated infection (SAI) is a major medical complication in acute ischemic stroke patients (AIS) treated with endovascular therapy (EVT). Three hundred thirty-three consecutive patients with AIS caused by a large vessel occlusion in the anterior circulation who received EVT (142 (42.6%) of them were given IV tPA as bridging therapy) and 337 AIS patients who received IV tPA only (non-EVT) were enrolled in the study and evaluated to determine the association of inflammatory factors on admission with SAI. Among the 333 AIS patients undergoing EVT, SAI occurred in 219 (65.8%) patients. Patients with SAI had higher baseline National Institutes of Health Stroke Scale (NIHSS) total scores, white blood cell (WBC) and neutrophil counts, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) than those without SAI (P < 0.05). The multivariable logistic regression analyses showed that older age in addition to higher diastolic blood pressure (DBP), NIHSS score, fasting blood glucose, WBC and neutrophil counts, NLR, and PLR were significantly associated with SAI (P < 0.05). However, these associations were not revealed in 337 non-EVT AIS patients. Furthermore, based on the inflammatory markers, we developed a nomogram that provided the opportunity for more accurate predictions (compared with conventional factors) and appeared a better prognostic tool for SAI according to the decision curve analysis. In summary, if proven externally valid, our nomogram that included WBC count, NLR, and PLR may be a useful tool for SAI prediction in clinical practice.

中风相关感染（SAI）是接受血管内治疗（EVT）治疗的急性缺血性中风患者（AIS）的主要医学并发症。333例因前循环大血管闭塞而导致的AIS连续患者接受了EVT（其中142例（42.6％）接受IV tPA桥接治疗）和337例仅接受IV tPA的AIS患者（非EVT）被纳入研究并进行评估，以确定入院时炎症因子与SAI的关联。在333例接受EVT的AIS患者中，有219例（65.8％）患者发生了SAI。SAI患者的基线美国国立卫生研究院卒中量表（NIHSS）总得分，白细胞（WBC）和中性粒细胞计数，中性粒细胞与淋巴细胞之比（NLR）和血小板与淋巴细胞之比（PLR）较高没有SAI（P  <0.05）。多变量逻辑回归分析表明，除较高的舒张压（DBP），NIHSS评分，空腹血糖，WBC和中性粒细胞计数，NLR和PLR之外，年龄与SAI显着相关（P  <0.05）。但是，在337例非EVT AIS患者中未发现这些关联。此外，基于炎症标记，我们开发了诺模图，它为更准确的预测提供了机会（与传统因素相比），并且根据决策曲线分析，它似乎是SAI的更好的预后工具。总而言之，如果经证明在外部有效，则包括WBC计数，NLR和PLR在内的列线图可能是临床实践中SAI预测的有用工具。