Anzeige
Erschienen in:
11.12.2019 | Original Article
Bilirubin: a novel predictor of hemorrhagic transformation and symptomatic intracranial hemorrhage after mechanical thrombectomy
Erschienen in: Neurological Sciences | Ausgabe 4/2020
Einloggen, um Zugang zu erhaltenAbstract
Background and purpose
The role of bilirubin in patients treated with mechanical thrombectomy (MT) is unknown. We investigated the relationship between admission bilirubin levels and hemorrhagic complication in acute ischemic stroke (AIS) patients treated with MT and detailed the roles of direct bilirubin (DB), indirect bilirubin (IDB), and total bilirubin (TB).
Methods
Consecutive AIS patients treated with MT were enrolled from two stroke centers. Outcome measures included hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) within 48 h. An independent association of bilirubin with outcomes was identified by multivariate logistic regression analysis. The accuracies of bilirubin in predicting outcome were evaluated using receiver operating characteristic curve analysis.
Results
Of the 153 enrolled patients, 64 (41.8%) were diagnosed with HT, of which 28 (18.3%) had sICH. In univariate analyses, DB, IDB, and TB were higher in patients with HT and sICH than in patients without. After adjustment for potential confounders, DB (odds ratio [OR], 1.364; 95% confidence interval [CI], 1.133–1.641; p = 0.001), IDB (OR, 1.143; 95% CI, 1.052–1.242; p = 0.002), and TB (OR, 1.106; 95% CI, 1.041–1.175; p = 0.001) were independently associated with HT. IDB (OR, 1.177; 95% CI, 1.064–1.303; p = 0.002) and TB (OR, 1.102; 95% CI, 1.027–1.182; p = 0.007) were independently associated with sICH. Receiver operating characteristic curve analysis showed no significant difference between the three indicators of predicting HT and sICH.
Conclusions
Elevated admission bilirubin is an independent predictor of HT and sICH in AIS patients treated with MT.