Infectious complications in young patients with acute ischemic stroke

Objective. To examine the prevalence of infectious complications (ICs) during the acute phase of ischemic stroke (IS) in young patients and to identify potential biomarkers for early diagnosis. Material and methods. This prospective and retrospective study included 150 patients diagnosed with acute IS at the Buyanov Moscow City Hospital, from 2023 to 2025. The cohort was divided into two groups: Group 1 comprised patients aged between 20 and 45 years (n=80; 19 females, 23.75%; mean age: 40.2±8.1 years), while Group 2 included 70 patients over 45 years (25 females, 35.71%; age range: 46—87 years, mean age: 66.4±10.1 years). The study assessed the incidence of ICs, the factors associated with their emergence, and the prognostic implications of ratios of blood cell counts as early markers for ICs. Results. Type 2 diabetes mellitus was statistically more prevalent in elderly patients with ICs (p<0.05). Conversely, in younger patients with an elevated risk of ICs, only a prior history of IS showed a significant association (p<0.05). The occurrence of ICs was significantly lower in younger patients compared to older patients (12.5% vs. 22.8%; p<0.05). However, ICs were correlated with more pronounced neurological deficits at discharge (mean NIHSS scores of 9.1±5.9 vs. 6.3±2.9, respectively; p<0.05). The earliest changes in the CRP/albumin ratio (p<0.001), D-dimer/albumin (p=0.015), and fibrinogen/albumin (p=0.022) were identified as the most significant predictors. A CRP/albumin ratio >0.3 indicates a high risk of ICs in young patients. Conclusion. In young patients, the presence of ICs complicates recovery of neurological function, underscoring the need for reliable markers for early detection.