【Abstract】 Objective To investigate the effects of saccharometabolism condition and nutritional risk index (NRI) on the occurrence of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods A retrospective analysis was performed on the clinical data of 213 AIS patients, and the patients were divided into an END group (n=56) or a non-END group (n=157) according to the occurrence of END within 3 days after admission. The multivariate logistic regression model was used to analyze the influencing factors for END occurrence in AIS patients, and the receiver operating characteristic (ROC) curve was used to evaluate the value of saccharometabolism condition and NRI in predicting the occurrence of END in AIS patients. Results There were statistically significant differences in the history of hypertension, saccharometabolism condition, National Institutes of Health Stroke Scale (NIHSS) score at admission, serum albumin level, and NRI between the two groups (all P<0.05). The results of multivariate logistic regression analysis showed that, after adding adjusting factors which included the history of hypertension and NIHSS score at admission, impaired glucose regulation (IGR) (OR=2.128, 95%CI: 0.866-5.229), diabetes mellitus (DM) (OR=3.497, 95%CI: 1.528-8.004), NRI<97.5 (OR=5.183, 95%CI: 2.132-12.600) were independent risk factors for the occurrence of END in AIS patients (all P<0.05). In predicting the occurrence of END in AIS patients, the areas under the ROC curves of saccharometabolism condition and NRI were 0.608 and 0.604, respectively (all P<0.05). Conclusion The saccharometabolism condition of IGR or DM and the NRI<97.5 are independent risk factors for the occurrence of END in AIS patients, and both the saccharometabolism condition and the NRI have certain value in predicting the occurrence of END in AIS patients.