The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data
ObjectiveTo assess the prognostic value of lipid profiles and their ratios, particularly the white blood cell to high-density lipoprotein (WBC/HDL) ratio, for predicting 28-day and 1-year all-cause mortality in ischemic stroke patients admitted to the ICU.MethodsA retrospective cohort study was cond...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1534381/full |
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| author | Li Zou Dong Sun Lei Zhang Yu Xie Renwei Zhang Huagang Li Bitang Dan Yumin Liu Bin Mei |
| author_facet | Li Zou Dong Sun Lei Zhang Yu Xie Renwei Zhang Huagang Li Bitang Dan Yumin Liu Bin Mei |
| author_sort | Li Zou |
| collection | DOAJ |
| description | ObjectiveTo assess the prognostic value of lipid profiles and their ratios, particularly the white blood cell to high-density lipoprotein (WBC/HDL) ratio, for predicting 28-day and 1-year all-cause mortality in ischemic stroke patients admitted to the ICU.MethodsA retrospective cohort study was conducted using the MIMIC-IV ICU database, including 2,894 ischemic stroke patients. Lipid profiles—including total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein—and derived ratios were analyzed. Associations with mortality were assessed using Cox proportional hazards models adjusted for demographic and clinical factors. Restricted cubic spline and Kaplan–Meier survival analyses were utilized to explore the relationship between the WBC/HDL ratio and mortality risk.ResultsTraditional lipid profiles and their ratios were not significantly associated with 28-day or 1-year mortality. Conversely, an elevated WBC/HDL ratio was independently associated with increased mortality risk at both 28 days (hazard ratio: 2.198; 95% confidence interval: 1.864–3.225) and 1 year (hazard ratio: 3.163; 95% confidence interval: 2.947–3.334). Restricted cubic spline analysis demonstrated a linear relationship between the WBC/HDL ratio and mortality risk, while Kaplan–Meier analyses indicated significantly poorer survival outcomes for patients with higher WBC/HDL ratios.InterpretationThe WBC/HDL ratio is a superior prognostic marker for mortality in ischemic stroke patients admitted to the ICU, outperforming traditional lipid profiles. Incorporating this measure into clinical practice may enhance early risk stratification and guide targeted interventions. |
| format | Article |
| id | doaj-art-2fdb651c4d924e3097eabb9bc60eb53b |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-2fdb651c4d924e3097eabb9bc60eb53b2025-08-20T03:13:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-04-011610.3389/fneur.2025.15343811534381The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV dataLi ZouDong SunLei ZhangYu XieRenwei ZhangHuagang LiBitang DanYumin LiuBin MeiObjectiveTo assess the prognostic value of lipid profiles and their ratios, particularly the white blood cell to high-density lipoprotein (WBC/HDL) ratio, for predicting 28-day and 1-year all-cause mortality in ischemic stroke patients admitted to the ICU.MethodsA retrospective cohort study was conducted using the MIMIC-IV ICU database, including 2,894 ischemic stroke patients. Lipid profiles—including total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein—and derived ratios were analyzed. Associations with mortality were assessed using Cox proportional hazards models adjusted for demographic and clinical factors. Restricted cubic spline and Kaplan–Meier survival analyses were utilized to explore the relationship between the WBC/HDL ratio and mortality risk.ResultsTraditional lipid profiles and their ratios were not significantly associated with 28-day or 1-year mortality. Conversely, an elevated WBC/HDL ratio was independently associated with increased mortality risk at both 28 days (hazard ratio: 2.198; 95% confidence interval: 1.864–3.225) and 1 year (hazard ratio: 3.163; 95% confidence interval: 2.947–3.334). Restricted cubic spline analysis demonstrated a linear relationship between the WBC/HDL ratio and mortality risk, while Kaplan–Meier analyses indicated significantly poorer survival outcomes for patients with higher WBC/HDL ratios.InterpretationThe WBC/HDL ratio is a superior prognostic marker for mortality in ischemic stroke patients admitted to the ICU, outperforming traditional lipid profiles. Incorporating this measure into clinical practice may enhance early risk stratification and guide targeted interventions.https://www.frontiersin.org/articles/10.3389/fneur.2025.1534381/fulllipid profileswhite blood cell to HDL ratiostroke mortalityinflammationMIMIC-IV database |
| spellingShingle | Li Zou Dong Sun Lei Zhang Yu Xie Renwei Zhang Huagang Li Bitang Dan Yumin Liu Bin Mei The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data Frontiers in Neurology lipid profiles white blood cell to HDL ratio stroke mortality inflammation MIMIC-IV database |
| title | The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data |
| title_full | The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data |
| title_fullStr | The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data |
| title_full_unstemmed | The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data |
| title_short | The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data |
| title_sort | wbc hdl ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients a retrospective cohort study using mimic iv data |
| topic | lipid profiles white blood cell to HDL ratio stroke mortality inflammation MIMIC-IV database |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1534381/full |
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