Correlation Between Serum Bilirubin Level And Early Neurological Deterioration In Patients With Acute Ischemic Stroke

Background and Objective: Early neurological deterioration(END)in patients with acute ischemic stroke is closely related to poor prognosis.END not only prolongs the hospitalization time of patients with cerebral infarction,but also significantly increases the mortality and disability rates of patients with cerebral infarction.This study aims to explore the relationship between serum bilirubin levels and early neurological deterioration in patients with acute ischemic stroke.Method: Collect acute ischemic stroke patients admitted to the Neurology Department of Xianyang Hospital,Yan’an University from October 2020 to October 2022,select 882 eligible patients,and complete routine laboratory tests such as fasting serum bilirubin within 24 hours,as well as skull imaging tests to exclude intracranial hemorrhage.Early neurological deterioration was evaluated using the National Institute of Health Stroke Scale(NIHSS).The quarter level of total bilirubin(TBIL)was the baseline feature of this study.It was divided into the END group and the non END group based on whether early neurological deterioration occurred.Univariate analysis was conducted on the risk factors associated with END,and further logistic regression analysis was conducted on the independent risk factors for the occurrence of END.Evaluate the performance of independent risk factors in predicting END using the receiver operating characteristic curve(ROC)and area under curve(AUC),and calculate the critical point by maximizing the Jordan index.Result: A total of 882 patients with acute ischemic stroke were included,of which 175(19.8%)had early neurological deterioration.In the univariate analysis,we found significant differences in albumin,CRP,admission NIHSS score,and TBIL between the END group and the non END group(P<0.05).Multiple logistic regression analysis showed that NIHSS score on admission(OR=1.456,95% CI=1.271-1.547 P<0.001);TBIL(OR=0.885,95% confidence interval CI=0.842-0.930 P<0.001)is an independent risk factor for END.Conclusion: Serum total bilirubin levels and baseline NIHSS scores are independent risk factors for early neurological deterioration in patients with acute ischemic stroke;The serum total bilirubin level is negatively correlated with early neurological deterioration in patients with acute ischemic stroke.