Prognostic Significance of the Neutrophil Percentage-to-Albumin Ratio in Ischemic Stroke Mortality

Ischemic stroke remains a leading cause of mortality and long-term disability globally, necessitating reliable prognostic markers for effective patient management and therapeutic stratification. This article explores the emerging role of the Neutrophil Percentage-to-Albumin Ratio (NPAR) as a novel and readily accessible prognostic indicator for mortality in patients suffering from ischemic stroke. Drawing upon current literature, we delve into the intricate pathophysiology of ischemic stroke, emphasizing the dual roles of inflammation (mediated by neutrophils) and protective mechanisms (attributed to albumin). The discussion highlights how an elevated NPAR reflects a heightened pro-inflammatory state and diminished antioxidant capacity, both detrimental in the acute phase of stroke. Evidence from various cardiovascular and critical illness contexts, alongside specific findings in ischemic stroke, supports NPAR's utility in predicting not only mortality but also stroke-associated infections and poor functional outcomes. This review synthesizes the current understanding of NPAR's predictive power, its underlying biological mechanisms, and discusses its potential clinical implications, while acknowledging the need for further large-scale prospective studies to validate its widespread application in clinical practice.