The advanced lung cancer inflammation index (ALI)—a composite marker integrating body mass index, albumin levels, and the neutrophil-to-lymphocyte ratio—has emerged as a potential prognostic tool for patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT), according to a new multicenter study.
Researchers from three stroke centers in China analyzed 784 AIS patients treated with IVT within 4.5 hours of symptom onset. Patients were followed for three months to assess functional outcomes using the modified Rankin Scale (mRS), with non-excellent outcome defined as mRS 2–6. ALI levels were significantly lower in patients with poor outcomes.
After adjusting for confounding factors, patients in the lowest ALI quartile had a substantially higher risk of non-excellent functional outcome compared with those in the highest quartile (odds ratio: 0.487; 95% confidence interval: 0.310–0.767). Restricted cubic spline analysis revealed a non-linear J-shaped relationship, with risk markedly elevated below the 25th percentile of ALI and plateauing thereafter, suggesting a threshold effect.
The findings indicate that reduced ALI levels are independently associated with poorer recovery following thrombolysis. As ALI is derived from routine clinical measures, it may offer a readily accessible biomarker to aid in early risk stratification for AIS patients undergoing IVT. The research, entitled “Relationship between Advanced Lung Cancer Inflammation Index and 3-month Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis” was published in Translational Neurology and Neurosurgery (Volume 1, Issue 1, 2026)
DOI：10.2738/TNN.2026.0002