title: Serum prealbumin is a predictive biomarker for stroke-associated infection after an ischemic stroke.
abstract: BACKGROUND
  Several prior studies have linked serum prealbumin (PA) as a predictor for perioperative infection. However, whether peripheral blood PA levels can be used as an indicator of stroke-associated infection (SAI) is still unclear. In this study, we attempt to find whether serum PA is a meaningful predictor in SAI after an ischemic stroke, so as to provide theoretical basis for clinical treatment.
  
  
  METHODS
  Consecutive patients with acute ischemic stroke who were admitted to our hospital were enrolled and serum PA was collected. A prospective study was conducted to observe the predictive value of PA in the SAI incident in ischemic stroke patients.
  
  
  RESULTS
  Of 104 patients, 29 (27.9%) developed an SAI after 7 d of follow-up. The stroke with SAI group had significantly lower PA levels than the stroke without SAI group (  p < 0.05). The optimal cutoff value for predicting SAI was PA ≤ 191 mg/L, with sensitivity and specificity of 58.62% and 81.33%, respectively. Kaplan-Meier survival analysis showed that stroke patients with low serum PA level (PA ≤ 191 mg/L) had a higher SAI rates (log-rank test, χ2= 16.870, p < 0.001). Cox regression analysis showed that PA ≤ 191 mg/L (hazard ratio = 3.207; 95% CI, 1.430-7.190, p = 0.005) was an independent risk factor for SAI.
  
  
  CONCLUSIONS
  Early detection of serum PA during the acute phase of ischemic stroke may help us to identify at-risk SAI patients, and hence rapidly guide the intervention to prevent SAI.
authors.affiliation: a Department of Geriatrics , The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , China.
authors.forename: Shan
authors.initials: S
authors.lastname: Ye
authors.affiliation: b Department of Emergency , The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , China.
authors.forename: Shao-Peng
authors.initials: SP
authors.lastname: Lin
authors.affiliation: c Department of Neurology , The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong Province , China.
authors.forename: Keping
authors.initials: K
authors.lastname: Wu
authors.affiliation: c Department of Neurology , The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong Province , China.
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Fan
authors.affiliation: a Department of Geriatrics , The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , China.
authors.forename: Miqing
authors.initials: M
authors.lastname: Xu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011228:Prealbumin / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood* / Q000150:complications
chemical_list: D015415:Biomarkers; D011228:Prealbumin
keywords: infection; prealbumin; prevention; risk assessment; stroke