ArticleCNS neuroscience & therapeutics2022
Predictive value of different bilirubin subtypes for clinical outcomes in patients with acute ischemic stroke receiving thrombolysis therapy.
Article in CNS neuroscience & therapeutics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Bilirubin as a predictor of severity and adverse clinical outcomes of acute ischemic stroke: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Beyond Hemoglobin Levels: Integrating Anemia Phenotyping Into Prognostic Models for Patients With Stroke Following Intravenous Thrombolysis.Journal of the American Heart Association · 2026Article
- Serum bilirubin concentrations in peritoneal dialysis patients are correlated with the initial onset of peritonitis.BMC nephrology · 2025Article
- Toward Precision Post-Stroke Rehabilitation Medicine: Integrating Molecular, Imaging, and Computational Biomarkers for Functional Outcome Prediction.Journal of clinical medicine · 2025Review
- Intrahepatic diffuse periportal hyperintensity patterns on hepatobiliary phase of gadoxetate-enhanced MRI: a non-invasive imaging biomarker for clinical stratification of liver injury.Abdominal radiology (New York) · 2025Article
- Intravenous Thrombolysis in Acute Ischemic Stroke: A Prognostic Prediction Model and the Role of Ischemic Core Growth Rate.CNS neuroscience & therapeutics · 2025Article
- The protective role of endothelial GLUT1 in ischemic stroke.Brain and behavior · 2024Review
- Subchronic toxic effects of bisphenol A on the gut-liver-hormone axis in rats via intestinal flora and metabolism.Frontiers in endocrinology · 2024Article
- Higher baseline serum bilirubin levels are associated with increased risk of early neurological deterioration in women with acute ischemic stroke.Frontiers in neurology · 2024Article
- Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients.CNS neuroscience & therapeutics · 2023Article
- High indirect bilirubin levels as an independent predictor of postoperative myasthenic crisis: a single-center, retrospective study.Frontiers in neurology · 2023Article
- Higher serum bilirubin levels are associated with hemorrhagic transformation after intravenous thrombolysis in acute ischemic Stroke.Frontiers in aging neuroscience · 2023Article
- Association between bilirubin levels with incidence and prognosis of stroke: A meta-analysis.Frontiers in neuroscience · 2023Article
- Specific subsystems of the inferior parietal lobule are associated with hand dysfunction following stroke: A cross-sectional resting-state fMRI study.CNS neuroscience & therapeutics · 2022Article
- Predictive value of different bilirubin subtypes for clinical outcomes in patients with acute ischemic stroke receiving thrombolysis therapy.CNS neuroscience & therapeutics · 2022Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo explore the association of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) levels with, as well as the incremental predictive value of different bilirubin subtypes for, poor outcomes in acute ischemic stroke patients after thrombolysis.
methodsWe analyzed 588 individuals out of 718 AIS participants, and all patients were followed up at 3 months after thrombolysis. The primary outcome was 3-month death and major disability (modified Rankin Scale (mRS) score of 3-6). The secondary outcomes were 3-month mortality (mRS score of 6), moderate-severe cerebral edema, and symptomatic intracranial hemorrhage (sICH), respectively.
resultsElevated DBIL pre-thrombolysis was associated with an increased risk of primary outcome (OR 3.228; 95% CI 1.595-6.535; p for trend = 0.014) after fully adjustment. Elevated TBIL pre-thrombolysis showed the similar results (OR 2.185; 95% CI 1.111-4.298; p for trend = 0.047), while IBIL pre-thrombolysis was not significantly associated with primary outcome (OR 1.895; 95% CI 0.974-3.687; p for trend = 0.090). Multivariable-adjusted spline regression model showed a positive linear dose-response relationship between DBIL pre-thrombolysis and risk of primary outcome (p for linearity = 0.004). Adding DBIL pre-thrombolysis into conventional model had greater incremental predictive value for primary outcome, with net reclassification improvement (NRI) 95% CI = 0.275 (0.084-0.466) and integrated discrimination improvement (IDI) 95% CI = 0.011 (0.001-0.024). Increased DBIL post-thrombolysis had an association with primary outcome (OR 2.416; 95%CI 1.184-4.930; p for trend = 0.039), and it also elevated the incremental predictive value for primary outcome, with NRI (95% CI) = 0.259 (0.066-0.453) and IDI (95% CI) = 0.025 (0.008-0.043).
conclusionIncreased DBIL pre-thrombolysis had a stronger association with, as well as greater incremental predictive value for, poor outcomes than TBIL and IBIL did in AIS patients after thrombolysis, which should be understood in the context of retrospective design. The effect of DBIL on targeted populations should be investigated in further researches.
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