Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, February 23, 2026

Serum alkaline phosphatase levels at admission are associated with unfavorable prognosis in acute ischemic stroke patients undergoing endovascular thrombectomy

 What is the EXACT FIX TO PREVENT THIS?

Why don't you know and do the work to get a solution? Predicting failure to recover is positively useless! You're fired!

Laziness? Incompetence? Or just don't care? NO leadership? NO strategy? Not my job? Not my Problem!

Serum alkaline phosphatase levels at admission are associated with unfavorable prognosis in acute ischemic stroke patients undergoing endovascular thrombectomy


  • 1. Department of Neurology, Hongze District People’s Hospital, Huaian, Jiangsu, China

  • 2. Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China

Abstract


Background: 

Limited data exist on the association between alkaline phosphatase (ALP) levels and outcomes in acute ischemic stroke patients undergoing endovascular thrombectomy. This study aimed to evaluate the relationship between serum ALP levels at admission and unfavorable prognosis following endovascular thrombectomy.


Methods: 

This retrospective study included patients who underwent mechanical thrombectomy for acute ischemic stroke (AIS) within 24 h of symptom onset at the Affiliated Hospital of Xuzhou Medical University between October 2018 and May 2025. Blood samples were collected upon admission in the emergency room. Unfavorable prognosis was defined as a modified Rankin Scale score of 3–6 at 90 days. Logistic regression analyses were conducted to examine the relationship between ALP levels and unfavorable prognosis.


Results: 

Of the 385 enrolled patients, 209 (54.3%) experienced an unfavorable prognosis. These patients exhibited significantly higher serum ALP levels (83.8 ± 29.5 U/L versus 76.1 ± 27.9 U/L; p = 0.009) compared to those with a favorable prognosis. A significant positive association was found between ALP levels (per 10-unit increase) and unfavorable prognosis (OR: 1.17, 95% CI: 1.06–1.29; p = 0.002) after adjusting for multiple variables. Patients in the highest ALP tertile had significantly higher odds of an unfavorable prognosis compared to those in the lowest tertile (OR: 3.17, 95% CI: 1.61–6.24; p = 0.001). The restricted cubic spline indicated a positive linear relationship between ALP levels and unfavorable prognosis (p for non-linearity = 0.461). The association between ALP levels and unfavorable prognosis remained stable across different subgroups (all p for interaction > 0.05).


Conclusion: 

Our findings demonstrate a positive association between serum ALP levels at admission and unfavorable prognosis in patients with AIS who underwent endovascular thrombectomy.

1 Introduction

Acute ischemic stroke (AIS) with large vessel occlusion (LVO) is a leading cause of death and disability worldwide (1). The primary objective is to restore cerebral blood flow using reperfusion therapies, such as intravenous alteplase and endovascular thrombectomy (ET) (2). Despite successful recanalization in more than 80% of AIS patients undergoing ET, functional dependence and mortality remain high, affecting about half of the cases (3). Several clinical and angiographic factors, including advanced age, hyperglycemia, higher baseline NIHSS scores, larger infarct volumes, longer onset-to-recanalization times, and poor collateral status, are linked to unfavorable outcomes (4).

Alkaline phosphatase (ALP) is a ubiquitous enzyme present in multiple isoenzymes, primarily found in the liver, bone, intestine, and kidney (5). Although its exact physiological function is not fully understood, ALP is believed to play roles in bone calcification, intestinal phosphate transport, and membrane transport processes (6). Serum ALP levels are commonly used as indicators of liver and renal damage (7, 8). Moreover, elevated serum ALP levels are associated with an increased risk of cardiovascular disease (CVD) (9), peripheral arterial disease (PAD) (10), and ischemic stroke (11). While the relationship between ALP levels and stroke prognosis is inconsistent (12), limited data focuses on patients undergoing thrombectomy. This study aims to investigate whether ALP levels at admission are associated with prognosis in AIS patients treated with thrombectomy.

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