Admission direct bilirubin and direct bilirubin-to-lymphocyte ratio as exploratory markers of early severity and in-hospital functional status in acute ischemic stroke
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Objectives To investigate the correlation between direct bilirubin (DBIL), direct bilirubin-lymphocyte ratio (DBLR), and the severity of acute ischemic stroke (AIS), and to evaluate their potential as auxiliary biomarkers for early severity assessment and short-term in-hospital functional outcome of AIS. Methods A retrospective study was conducted to enroll 234 patients with AIS who presented within 24 h of admission to The First Hospital of Lanzhou University as the AIS Group, and 180 healthy individuals who underwent a health checkup at the same time were randomly selected as the Control Group. The patients' general information, National Institute of Health Stroke Scale (NIHSS) scores, and laboratory indicators at admission were collected with DBLR calculated as DBIL divided by lymphocyte (LYM) count. The AIS Group was divided into Mild Group (NIHSS ≤ 6,= 91), Moderate Group (6 2.86 indicated a higher risk of poor short-term functional status. Conclusions Admission levels of DBIL and DBLR are significantly correlated with the degree of neurological impairment and short-term (7 ± 2 days) in-hospital functional status in AIS patients, where higher values indicate more severe acute neurological deficits and poorer early outcomes. Elevated DBLR is independently associated with poor short-term functional status, and the exploratory cutoff of DBLR > 2.86 (OR = 5.169, 95% CI: 1.623–16.461,= 0.005) may assist in early risk stratification. However, their independent predictive abili
Abstract
Objectives To investigate the correlation between direct bilirubin (DBIL), direct bilirubin-lymphocyte ratio (DBLR), and the severity of acute ischemic stroke (AIS), and to evaluate their potential as auxiliary biomarkers for early severity assessment and short-term in-hospital functional outcome of AIS. Methods A retrospective study was conducted to enroll 234 patients with AIS who presented within 24 h of admission to The First Hospital of Lanzhou University as the AIS Group, and 180 healthy individuals who underwent a health checkup at the same time were randomly selected as the Control Group. The patients' general information, National Institute of Health Stroke Scale (NIHSS) scores, and laboratory indicators at admission were collected with DBLR calculated as DBIL divided by lymphocyte (LYM) count. The AIS Group was divided into Mild Group (NIHSS ≤ 6,= 91), Moderate Group (6 2.86 indicated a higher risk of poor short-term functional status. Conclusions Admission levels of DBIL and DBLR are significantly correlated with the degree of neurological impairment and short-term (7 ± 2 days) in-hospital functional status in AIS patients, where higher values indicate more severe acute neurological deficits and poorer early outcomes. Elevated DBLR is independently associated with poor short-term functional status, and the exploratory cutoff of DBLR > 2.86 (OR = 5.169, 95% CI: 1.623–16.461,= 0.005) may assist in early risk stratification. However, their independent predictive ability is limited (all AUCs < 0.7). Therefore, these biomarkers should only be used as auxiliary tools in combination with clinical scores such as the NIHSS, and their clinical value should not be overinterpreted.