Background: Acute ischemic stroke (AIS) is a major cause of morbidity and mortality worldwide. Identifying reliable prognostic biomarkers is crucial for managing AIS effectively.

Methods: This prospective observational study included 125 AIS patients. Serum albumin and CRP levels were measured at admission, 48 hours, 72 hours, and at discharge. Patients were followed up for six months, focusing on mortality, functional recovery, and post-stroke complications.

Results: Lower serum albumin and higher CRP levels at admission were significantly associated with increased stroke severity and poorer outcomes. The mortality rate at 6-month follow-up was 12%. Each g/dL decrease in albumin increased the odds of adverse outcomes by 25% (Odds Ratio 0.75, 95% CI 0.62 - 0.91, p < 0.05), and each unit increase in CRP was associated with a 5% increase in the odds of adverse outcomes (Odds Ratio 1.05, 95% CI 1.01 - 1.09, p < 0.05). A significant negative correlation was observed between serum albumin and CRP levels (correlation coefficient -0.52, p < 0.01 at 72 hours).

Conclusion: Serum albumin and CRP levels are significant prognostic biomarkers in AIS, associated with stroke severity and outcomes. Their routine assessment could aid in risk stratification and management of AIS patients.