Procalcitonin to C-reactive protein ratio is associated with short-term mortality in ischemic stroke patients: preliminary report

Introduction: Inflammation is associated with the development and progression of ischemic stroke. In this study, we tested the diagnostic ability of procalcitonin (PCT) to C-reactive protein (CRP) ratio (PC ratio; x10(-6)) to predict 90-day mortality in ischemic stroke patients. Material and methods: We retrospectively collected the medical records of patients with a diagnosis of ischemic stroke from February 2008 to January 2018. We analyzed the data of study patients with both PCT and CRP results, and evaluated the relationship between PC ratio and 90-day mortality. Logistic regression was adjusted for confounders and survival analysis was conducted using the Kaplan-Meier estimation. Results: A total of 333 patients were analyzed in this study. As compared with the lowest PC ratio quartile (0-2.1), the odds ratios for 90-day mortality were; 1.47 (95% CI: 0.62-4.20) for the 2nd quartile (2.2-6.3, p = 0.440), 2.54 (95% CI: 0.95-5.91) for the 3rd quartile (6.4-19.6, p = 0.048), and 4.10 (95% CI: 1.73-9.80) for the 4th quartile (>= 19.7, p = 0.002), after adjusting for age, sex, medical history, and laboratory results. A higher PC ratio (>= 2.2) was associated with higher mortality (p < 0.05) in ischemic stroke patients in Kaplan-Meier estimation, and this was confirmed by the log-rank test (p < 0.001). Conclusions: Procalcitonin to C-reactive protein ratio was found to be positively associated with 90-day mortality in ischemic stroke patients. Our findings indicate that PC ratio may be a useful marker for predicting mortality after ischemic stroke. Further prospective studies are required to investigate and validate the use of PC ratio in clinical practice.