The lactate-to-albumin ratio as a novel predictor for post-stroke epilepsy: insights from a large cohort.
6 affiliations
- 1Department of Endocrinology and Metabolism, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.
- 2Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi 330006, China.
- 3Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang University, Nanchang, Jiangxi 330006, China.
- 4Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.
- 5Department of Rehabilitation Medicine, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China.
- 6Department of Neurosurgery, Jiangxi Key Laboratory of Neurological Diseases, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.
Abstract
Ischaemic stroke (IS) represents a leading cause of adult mortality and long-term disability globally, and post-stroke epilepsy (PSE) constitutes a severe complication that worsens neurological recovery and reduces quality of life, yet reliable early predictive biomarkers remain insufficient. The serum lactate-to-albumin ratio (LAR, mmol/g), an integrated indicator reflecting hypoxic-ischaemic stress, energy metabolic disturbance, and systemic inflammation, has emerged as a promising prognostic marker but has not been investigated for predicting PSE risk. This multicentre retrospective cohort study enrolled 21 459 acute IS patients from four centres to examine the association between admission LAR and 1-year PSE incidence. Multivariable logistic regression, restricted cubic spline (RCS) analysis, subgroup stratification, and sensitivity testing were applied for statistical evaluation. Overall, 936 patients (4.36%) developed PSE within one year. In the fully adjusted model, each 1-unit increment in LAR was associated with an odds ratio (OR) of 1.13 (95% CI: 1.04-1.22, P = 0.003) for PSE. Compared with the lowest LAR quartile (Q1), the highest quartile (Q4) conferred a markedly elevated risk (OR = 12.02, 95% CI: 7.91-18.90, P < 0.001), with a significant non-linear dose-response relationship and an inflection point at LAR = 0.06. The association was stronger in patients with atrial fibrillation or cortical stroke lesions, and sensitivity analyses confirmed result robustness. Taken together, these data indicate that serum LAR measured at admission behaves as an independent, non-linear correlate of PSE risk after acute IS. As a readily available biomarker derived from routine serum laboratory tests, LAR may serve as a promising candidate for early risk stratification in IS patients, although prospective studies are warranted to confirm its clinical utility.
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BibTeX
@article{chen2026lactatetoalbumin,
title = {{The lactate-to-albumin ratio as a novel predictor for post-stroke epilepsy: insights from a large cohort.}},
author = {Dandan Chen and Yuanlin Liu and Yingru Zhou and Qi Yang and Xiao Wu and Yunliang Tang},
journal = {Brain communications},
year = {2026},
month = oct,
doi = {10.1093/braincomms/fcag391},
url = {https://europepmc.org/article/MED/42948276},
note = {CC BY},
}
RIS
TY - JOUR
TI - The lactate-to-albumin ratio as a novel predictor for post-stroke epilepsy: insights from a large cohort.
AU - Dandan Chen
AU - Yuanlin Liu
AU - Yingru Zhou
AU - Qi Yang
AU - Xiao Wu
AU - Yunliang Tang
PY - 2026
DA - 2026/10/15
JO - Brain communications
DO - 10.1093/braincomms/fcag391
UR - https://europepmc.org/article/MED/42948276
AB - Ischaemic stroke (IS) represents a leading cause of adult mortality and long-term disability globally, and post-stroke epilepsy (PSE) constitutes a severe complication that worsens neurological recovery and reduces quality of life, yet reliable early predictive biomarkers remain insufficient. The serum lactate-to-albumin ratio (LAR, mmol/g), an integrated indicator reflecting hypoxic-ischaemic stress, energy metabolic disturbance, and systemic inflammation, has emerged as a promising prognostic marker but has not been investigated for predicting PSE risk. This multicentre retrospective cohort study enrolled 21 459 acute IS patients from four centres to examine the association between admission LAR and 1-year PSE incidence. Multivariable logistic regression, restricted cubic spline (RCS) analysis, subgroup stratification, and sensitivity testing were applied for statistical evaluation. Overall, 936 patients (4.36%) developed PSE within one year. In the fully adjusted model, each 1-unit increment in LAR was associated with an odds ratio (OR) of 1.13 (95% CI: 1.04-1.22, P = 0.003) for PSE. Compared with the lowest LAR quartile (Q1), the highest quartile (Q4) conferred a markedly elevated risk (OR = 12.02, 95% CI: 7.91-18.90, P < 0.001), with a significant non-linear dose-response relationship and an inflection point at LAR = 0.06. The association was stronger in patients with atrial fibrillation or cortical stroke lesions, and sensitivity analyses confirmed result robustness. Taken together, these data indicate that serum LAR measured at admission behaves as an independent, non-linear correlate of PSE risk after acute IS. As a readily available biomarker derived from routine serum laboratory tests, LAR may serve as a promising candidate for early risk stratification in IS patients, although prospective studies are warranted to confirm its clinical utility.
SN - 2632-1297
ER -