Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage
BackgroundIntracerebral hemorrhage (ICH) is associated with high mortality and morbidity rates. Although some studies have indicated a correlation between serum bilirubin levels and ICH severity, evidence of the relationship between serum total bilirubin (TBIL) and ICH outcomes remains lacking.Metho...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1529415/full |
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| author | Dachang Qiu Guangwei Li Yongfei Dong Yongfei Dong |
| author_facet | Dachang Qiu Guangwei Li Yongfei Dong Yongfei Dong |
| author_sort | Dachang Qiu |
| collection | DOAJ |
| description | BackgroundIntracerebral hemorrhage (ICH) is associated with high mortality and morbidity rates. Although some studies have indicated a correlation between serum bilirubin levels and ICH severity, evidence of the relationship between serum total bilirubin (TBIL) and ICH outcomes remains lacking.MethodsA total of 914 patients from the Medical Information Mart for Intensive Care IV database met the eligibility criteria and were included in the study. The patients were categorized into two groups based on whether they survived for 28 days following admission to hospital. The association between serum TBIL levels and 28-day survival in patients with ICH was investigated using Spearman’s correlation analysis and restricted cubic splines. The effect of serum TBIL levels on survival time and rate in the 28-day period was analyzed using Kaplan–Meier curves and restricted mean survival times. Univariate Cox regression, least absolute shrinkage and selection operator regression, and multivariate Cox regression were used to identify risk factors associated with 28-day all-cause mortality. Finally, subgroup analysis was performed to verify the stability of the association between serum TBIL levels and 28-day all-cause mortality in patients with ICH.ResultsA negative relationship was revealed between TBIL levels and survival (p < 0.001, correlation = −0.174). Restricted cubic spline analysis revealed a nonlinear link between mean serum TBIL levels and 28-day all-cause mortality (p for nonlinear = 0.001). Patients with ICH and higher serum TBIL levels had significantly reduced survival times and rates compared with those with lower serum TBIL levels (p < 0.001). Serum TBIL level was identified as a significant risk factor for 28-day all-cause mortality in patients with ICH (hazard ratio [95% confidence interval] = 1.121 [1.063–1.182], p < 0.001). Subgroup analyses revealed that the assessed variables had no influence on the association between serum TBIL levels and 28-day all-cause mortality.ConclusionHigher serum TBIL levels are associated with a greater risk of mortality within 28 days in patients with ICH, whereas lower serum TBIL levels are associated with prolonged survival. |
| format | Article |
| id | doaj-art-2c95c5dcd66d4edeba3fc7c374729f5d |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-2c95c5dcd66d4edeba3fc7c374729f5d2025-02-12T05:15:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-02-011610.3389/fneur.2025.15294151529415Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhageDachang Qiu0Guangwei Li1Yongfei Dong2Yongfei Dong3Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaInstitute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, Anhui, ChinaWuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, ChinaBackgroundIntracerebral hemorrhage (ICH) is associated with high mortality and morbidity rates. Although some studies have indicated a correlation between serum bilirubin levels and ICH severity, evidence of the relationship between serum total bilirubin (TBIL) and ICH outcomes remains lacking.MethodsA total of 914 patients from the Medical Information Mart for Intensive Care IV database met the eligibility criteria and were included in the study. The patients were categorized into two groups based on whether they survived for 28 days following admission to hospital. The association between serum TBIL levels and 28-day survival in patients with ICH was investigated using Spearman’s correlation analysis and restricted cubic splines. The effect of serum TBIL levels on survival time and rate in the 28-day period was analyzed using Kaplan–Meier curves and restricted mean survival times. Univariate Cox regression, least absolute shrinkage and selection operator regression, and multivariate Cox regression were used to identify risk factors associated with 28-day all-cause mortality. Finally, subgroup analysis was performed to verify the stability of the association between serum TBIL levels and 28-day all-cause mortality in patients with ICH.ResultsA negative relationship was revealed between TBIL levels and survival (p < 0.001, correlation = −0.174). Restricted cubic spline analysis revealed a nonlinear link between mean serum TBIL levels and 28-day all-cause mortality (p for nonlinear = 0.001). Patients with ICH and higher serum TBIL levels had significantly reduced survival times and rates compared with those with lower serum TBIL levels (p < 0.001). Serum TBIL level was identified as a significant risk factor for 28-day all-cause mortality in patients with ICH (hazard ratio [95% confidence interval] = 1.121 [1.063–1.182], p < 0.001). Subgroup analyses revealed that the assessed variables had no influence on the association between serum TBIL levels and 28-day all-cause mortality.ConclusionHigher serum TBIL levels are associated with a greater risk of mortality within 28 days in patients with ICH, whereas lower serum TBIL levels are associated with prolonged survival.https://www.frontiersin.org/articles/10.3389/fneur.2025.1529415/fulltotal serum bilirubinintracerebral hemorrhage28 days all-cause mortalityMIMIC-IV databaseprognosis |
| spellingShingle | Dachang Qiu Guangwei Li Yongfei Dong Yongfei Dong Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage Frontiers in Neurology total serum bilirubin intracerebral hemorrhage 28 days all-cause mortality MIMIC-IV database prognosis |
| title | Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage |
| title_full | Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage |
| title_fullStr | Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage |
| title_full_unstemmed | Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage |
| title_short | Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage |
| title_sort | association between serum total bilirubin levels and 28 day all cause mortality after intracerebral hemorrhage |
| topic | total serum bilirubin intracerebral hemorrhage 28 days all-cause mortality MIMIC-IV database prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1529415/full |
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