Objective: To evaluate the association and in-sample discriminative performance of systemic inflammatory markers (NLR, PLR, SII) and RDW for short-term neurological outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis.
Subjects and Methods: An observational study with longitudinal follow-up was conducted on 105 patients with acute ischemic stroke treated with alteplase at Military Hospital 103 from January 2025 to April 2026.
Results: The rate of poor neurological outcome was 36.2%. Patients with poor outcomes had significantly higher NLR and SII values than those with good outcomes (NLR: 3.54 vs. 2.36; p = 0.008; SII: 817.7 vs. 530.8; p = 0.042). Discrimination for poor outcome was only low (AUC 0.657; 95% CI 0.545–0.769 for NLR and 0.620; 95% CI 0.500–0.739 for SII). After adjustment for admission NIHSS, neither NLR nor SII remained independent (p = 0.377 and 0.207, respectively); only admission NIHSS ≥ 15 remained an independent prognostic factor (adjusted OR 21.237, 95% CI 5.501–81.986, p = 0.001).
Conclusions: Elevated NLR and SII at admission were associated with poorer neurological outcomes, but their discriminative ability was low and neither remained an independent predictor after adjustment for admission NIHSS. The cutoffs were derived within the same sample and should be regarded as exploratory, requiring further validation.