<h4>Objective</h4>To investigate whether a multi-marker panel comprising PAI-1, NLR, and MMP-9 enhances prognostication beyond the NIHSS score in elderly patients with acute ischemic stroke, and to develop a clinically applicable nomogram.<h4>Methods</h4>A total of 113 elderly AIS patients and 63 elderly non-AIS controls were prospectively enrolled. The gene discussed is MMP9; the disease is androgen insensitivity syndrome.