Decreased Serum Total Bilirubin Level Predicts Early Neurological Deterioration in Patients with Acute Ischemic Stroke

OBJECTIVE: This study aimed to investigate the relationship between serum total bilirubin (TBil) level and early neurological deterioration (END) in patients with acute ischemic stroke of large artery atherosclerosis. PATIENTS AND METHODS: In this retrospective study, a total of 291 patients with acute ischemic stroke were enrolled. The demographic and laboratory dates were collected. Stroke severity had been assessed using the National Institutes of Health Stroke Scale (NIHSS). Multivariable logistic regression was used to examine the independent association between TBil and END. RESULTS: Approximately 63 (21.6%) of the patients were diagnosed with END within the first seven days. The proportion of hypertension, diabetes mellitus (DM) and previous stroke/transient ischemic attack (TIA) was significant greater in the lowest quartile (<9.8 μmol/l) of TBil. The proportion of patients with an elevated TBil levels was significantly lower in the END group than in the non-END group. After controlling for covariates, the first quartiles (<9.8 μmol/l) of TBil were still associated with END. In addition, an increased level of CRP and age were also associated with an increased risk of END. CONCLUSION: The TBil levels in patients with acute cerebral infarction may be a useful biomarker for the prediction of END.