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...

Full description

Saved in:
Bibliographic Details
Main Authors: Li Zou, Dong Sun, Lei Zhang, Yu Xie, Renwei Zhang, Huagang Li, Bitang Dan, Yumin Liu, Bin Mei
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1534381/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849714088355037184
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.
record_format Article
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
work_keys_str_mv AT lizou thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT dongsun thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT leizhang thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT yuxie thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT renweizhang thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT huagangli thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT bitangdan thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT yuminliu thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT binmei thewbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT lizou wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT dongsun wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT leizhang wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT yuxie wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT renweizhang wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT huagangli wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT bitangdan wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT yuminliu wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata
AT binmei wbchdlratiooutperformsotherlipidprofilesinpredictingmortalityamongischemicstrokepatientsaretrospectivecohortstudyusingmimicivdata