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Introduction: Hemorrhagic transformation (HT) is a severe but frequent complication of acute ischemic stroke (AIS). This study aimed to evaluate the relationship between serum lactate dehydrogenase (LDH) levels and HT. Methods: We retrospectively included 542 AIS patients with HT and 1,091 age- and gender-matched patients without HT. Demographic and clinical data were obtained from medical records, and blood samples were obtained within 24 h after admission. The characteristics of the groups were compared. With the receiver operating characteristic (ROC) curve analysis, we assessed the discriminating capacity of LDH levels in predicting HT in patients with AIS. The logistic regression model was used to determine the connection between LDH and HT. Results: The HT group had considerably higher LDH levels than the non-HT group (263.0 [216.0–323.3] U/L versus 178.0 [162.0–195.0] U/L, p < 0.001). We also observed that the levels of LDH in the parenchymal hemorrhage subgroup were significantly higher than those in the hemorrhagic infarction subgroup (281.0 [230.0–340.0] U/L versus 258.0 [209.0–311.0] U/L, p < 0.001). The area under the ROC curve of LDH was 0.890 (95% confidence level [CI] 0.874–0.905, p < 0.001). Besides, logistic regression revealed that high LDH levels (LDH >215 U/L) showed a higher risk of HT (odds ratio = 10.958, 95% CI 7.964–15.078, p < 0.001). Conclusion: High LDH levels were linked with an increased risk of HT in AIS patients. Practical measures should be considered in patients with increased LDH levels (LDH >215 U/L). [ABSTRACT FROM AUTHOR]

Introduction: Several studies have examined the crucial role of inflammatory indexes such as the ratio of monocyte and lymphocyte (MLR), systemic-immune-inflammation-index, and the ratio of neutrophil and lymphocyte (NLR) in stroke-associated pneumonia (SAP). However, the function of the systemic inflammation response index (SIRI) in SAP is not known. This study investigated whether SIRI at admission could predict the incidence of SAP in patients with acute ischemic stroke (AIS). Patients and Methods: 2,802 AIS patients collected from 2013 to 2021 were divided into the SAP and non-SAP groups. The predictive performance of SIRI in SAP was evaluated by the receiver operating characteristic curve. Multivariate regression analysis and the restricted cubic spline (RCS) were performed to explore the relationship between SIRI and SAP risk. Results: The SIRI at admission in SAP patients was significantly higher than that in non-SAP patients (median [IQR]: 3.75 [2.05, 6.99] vs. 1.51 [0.94, 2.62], p < 0.001). SIRI had a predictive ability for predicting the incidence of SAP with area under the curve of 0.757, better than NLR and MLR (both p < 0.05). SIRI ≥2.74 was an independent risk factor for the incidence of SAP (odds ratio: 5.82, 95% confidence interval: 4.54, 7.49, p < 0.001). The RCS model showed an increasing trend of the SAP risk with the increase of SIRI. Conclusion: SIRI showed a good predictive value for SAP. In clinical practice, AIS patients with high SIRI levels (SIRI ≥2.74) should be aware of the risk of SAP. [ABSTRACT FROM AUTHOR]