Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Author:

Chen Jiahao1,Chen Yiting2,Lin Yisi1,Long Jingfang1,Chen Yufeng3,He Jincai1,Huang Guiqian1

Affiliation:

1. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

2. School of Foreign Language Studies, Wenzhou Medical University, Wenzhou 325000, China

3. Department of General Practice, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

Abstract

Background: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT). Methods: The study population consisted of 408 consecutive AIS patients with HT and age- and sex-matched patients without HT. All patients were divided into quartiles according to total bilirubin (TBIL) level. HT was classified as hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on radiographic data. Results: In this study, the baseline TBIL levels were significantly higher in the HT than non-HT patients in both cohorts (p < 0.001). Furthermore, the severity of HT increased with increasing TBIL levels (p < 0.001) in sHT and tHT cohorts. The highest quartile of TBIL was associated with HT in sHT and tHT cohorts (sHT cohort: OR = 3.924 (2.051–7.505), p < 0.001; tHT cohort: OR = 3.557 (1.662–7.611), p = 0.006). Conclusions: Our results suggest that an increased TBIL is associated with a high risk of patients with sHT and tHT, and that TBIL is more suitable as a predictor for sHT than tHT. These findings may help to identify patients susceptible to different types and severity of HT.

Funder

Projects of National Natural Science Foundation of China

Wenzhou Municipal Sci-Tech Bureau Program

Publisher

MDPI AG

Subject

General Medicine

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