Abstract: Objective To explore the predictive value of the global immune-nutrition-inflammation index (GINI) for 90-day prognosis of elderly patients with first-onset acute minor ischemic stroke (AMIS). Methods A total of 371 elderly patients diagnosed with first-onset AMIS admitted to the Stroke Center of the Affiliated Hospital of Jiangsu University from July 2021 to July 2023 were included. Based on the modified Rankin Scale score (mRS) at 90 days, patients were categorized into a favorable prognosis group (mRS ≤ 2, n=337) and a poor prognosis group (mRS > 2, n=34). Comparative analysis of general clinical data was performed between the two groups. Multivariate logistic regression analysis was employed to identify independent risk factors associated with poor prognosis. Receiver operating characteristic (ROC) curve analysis was utilized to assess the predictive value of GINI for 90-day poor prognosis. Results In comparison to the favorable prognosis group, the poor prognosis group exhibited higher enrichments of red blood cells and monocytes, alongside a more pronounced inflammatory response characterized by elevated levels of C-reactive protein and neutrophils. This group also experienced more severe neurological impairment, larger infarct volume, and extended hospital stay (P<0.05). Multivariate logistic regression analysis revealed that GINI was an independent predictor of prognosis at 90-day in elderly patients with AMIS (OR=1.576, 95%CI: 1.219－2.072, P<0.05). ROC curve analysis demonstrated that the area under the curve of GINI for predicting poor prognosis in the elderly first-onset AMIS patients was 0.759 (95%CI: 0.692－0.827, P<0.05) with an optimal cutoff value of 1.689. Conclusions GINI is independently associated with poor prognosis at 90-day in elderly patients with first-onset AMIS, and may serve as a potential predictive factor.

Key words: global immune-nutrition-inflammation index, aged, ischemic stroke, prognosis, inflammation