Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database

Abstract Background The relationship between lipid profiles and intracranial hemorrhage (ICH) has garnered increasing attention. The ratio of low-density lipoprotein to high-density lipoprotein (LHR) is one of the key lipid profile indices. However, studies investigating the association between LHR...

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Main Authors: Yuchen Liu, Houxin Fu, Yue Wang, Yi Zhong, Rongting Zhang, Jingxuan Sun, Tianquan Yang, Yong Han, Yongjun Xiang, Bin Yuan, Ruxuan Zhou, Min Chen, Hangzhou Wang
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02459-z
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author Yuchen Liu
Houxin Fu
Yue Wang
Yi Zhong
Rongting Zhang
Jingxuan Sun
Tianquan Yang
Yong Han
Yongjun Xiang
Bin Yuan
Ruxuan Zhou
Min Chen
Hangzhou Wang
author_facet Yuchen Liu
Houxin Fu
Yue Wang
Yi Zhong
Rongting Zhang
Jingxuan Sun
Tianquan Yang
Yong Han
Yongjun Xiang
Bin Yuan
Ruxuan Zhou
Min Chen
Hangzhou Wang
author_sort Yuchen Liu
collection DOAJ
description Abstract Background The relationship between lipid profiles and intracranial hemorrhage (ICH) has garnered increasing attention. The ratio of low-density lipoprotein to high-density lipoprotein (LHR) is one of the key lipid profile indices. However, studies investigating the association between LHR and the prognosis of critically ill ICH patients remain limited. Methods Data for this study were obtained from the MIMIC-IV 3.1 database. Initially, the association between LHR and short-term outcomes in ICH patients, including ICU mortality, in-hospital mortality, and 28-day mortality, was analyzed using Cox regression in both continuous and categorical models. Additionally, restricted cubic spline (RCS), subgroup, and sensitivity analyses were conducted to further validate our findings. Results The study included 873 critically ill ICH patients, among whom 20.3% (177/873) succumbed within 28 days. Higher LHR was independently associated with lower short-term mortality in ICH patients (28-day mortality: HR = 0.82, 95% CI: 0.68 ~ 0.99, P = 0.039; In-hospital mortality: HR = 0.7, 95% CI: 0.55 ~ 0.89, P = 0.004; ICU mortality: HR = 0.66, 95% CI: 0.48 ~ 0.92, P = 0.015). The RCS revealed a linear relationship between LHR and short-term all-cause mortality. Subgroup analyses demonstrated consistent results. The optimal cutoff value for LHR was determined to be 1.21. Comparing the mortality risk between the low-LHR and high-LHR groups, the high-LHR group exhibited higher survival rates (28-day mortality, P = 0.0052; In-hospital mortality, P = 0.019; ICU mortality, P = 0.044). Furthermore, higher LHR was also correlated with lower disease severity scores (SAPS-II: r = -0.158, P < 0.001, OASIS: r = -0.117, P = 0.006). Conclusion LHR was negatively associated with short-term mortality in critically ill ICH patients. It may aid clinicians in identifying high-risk individuals and providing timely interventions.
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spelling doaj-art-0d5a156143804dc19d523c86709e657c2025-02-09T12:52:36ZengBMCLipids in Health and Disease1476-511X2025-02-0124111110.1186/s12944-025-02459-zAssociation between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV databaseYuchen Liu0Houxin Fu1Yue Wang2Yi Zhong3Rongting Zhang4Jingxuan Sun5Tianquan Yang6Yong Han7Yongjun Xiang8Bin Yuan9Ruxuan Zhou10Min Chen11Hangzhou Wang12Department of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Pediatric Hematology and Oncology, Children’s Hospital of Soochow UniversityInstitute of Pediatric Research, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Children’s Hospital of Soochow UniversityAbstract Background The relationship between lipid profiles and intracranial hemorrhage (ICH) has garnered increasing attention. The ratio of low-density lipoprotein to high-density lipoprotein (LHR) is one of the key lipid profile indices. However, studies investigating the association between LHR and the prognosis of critically ill ICH patients remain limited. Methods Data for this study were obtained from the MIMIC-IV 3.1 database. Initially, the association between LHR and short-term outcomes in ICH patients, including ICU mortality, in-hospital mortality, and 28-day mortality, was analyzed using Cox regression in both continuous and categorical models. Additionally, restricted cubic spline (RCS), subgroup, and sensitivity analyses were conducted to further validate our findings. Results The study included 873 critically ill ICH patients, among whom 20.3% (177/873) succumbed within 28 days. Higher LHR was independently associated with lower short-term mortality in ICH patients (28-day mortality: HR = 0.82, 95% CI: 0.68 ~ 0.99, P = 0.039; In-hospital mortality: HR = 0.7, 95% CI: 0.55 ~ 0.89, P = 0.004; ICU mortality: HR = 0.66, 95% CI: 0.48 ~ 0.92, P = 0.015). The RCS revealed a linear relationship between LHR and short-term all-cause mortality. Subgroup analyses demonstrated consistent results. The optimal cutoff value for LHR was determined to be 1.21. Comparing the mortality risk between the low-LHR and high-LHR groups, the high-LHR group exhibited higher survival rates (28-day mortality, P = 0.0052; In-hospital mortality, P = 0.019; ICU mortality, P = 0.044). Furthermore, higher LHR was also correlated with lower disease severity scores (SAPS-II: r = -0.158, P < 0.001, OASIS: r = -0.117, P = 0.006). Conclusion LHR was negatively associated with short-term mortality in critically ill ICH patients. It may aid clinicians in identifying high-risk individuals and providing timely interventions.https://doi.org/10.1186/s12944-025-02459-zLow-density lipoprotein to high-density lipoprotein ratio (LHR)MIMIC-IVIntracerebral hemorrhageLipid metabolismPrognosis
spellingShingle Yuchen Liu
Houxin Fu
Yue Wang
Yi Zhong
Rongting Zhang
Jingxuan Sun
Tianquan Yang
Yong Han
Yongjun Xiang
Bin Yuan
Ruxuan Zhou
Min Chen
Hangzhou Wang
Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
Lipids in Health and Disease
Low-density lipoprotein to high-density lipoprotein ratio (LHR)
MIMIC-IV
Intracerebral hemorrhage
Lipid metabolism
Prognosis
title Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
title_full Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
title_fullStr Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
title_full_unstemmed Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
title_short Association between the low-density lipoprotein to high-density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients: a retrospective cohort study from the MIMIC-IV database
title_sort association between the low density lipoprotein to high density lipoprotein ratio and prognosis in critically ill intracerebral hemorrhage patients a retrospective cohort study from the mimic iv database
topic Low-density lipoprotein to high-density lipoprotein ratio (LHR)
MIMIC-IV
Intracerebral hemorrhage
Lipid metabolism
Prognosis
url https://doi.org/10.1186/s12944-025-02459-z
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