Serum albumin and total bilirubin are associated with poor outcomes in patients with acute ischemic stroke

Background

Few studies have investigated the correlation between serum liver function indices and clinical outcomes in acute ischemic stroke (AIS) patients.

Methods

Patients with AIS from January 2020 to March 2023 were retrospectively analyzed. The clinical outcomes included stroke severity at admission and poor prognosis at discharge and 3 months. Multivariate logistic regression was used to evaluate the associations of liver function indicators with risk and adverse outcomes. Subgroup analysis was conducted to explore the relationships between liver function indices and clinical outcomes. The predictive value of these indices for adverse outcomes was assessed via receiver operating characteristic (ROC) curves.

Results

A total of 2022 AIS patients were included in this study. After adjustment for confounding factors, lower albumin levels were associated with higher NIHSS scores at admission (OR = 0.924, 95 % CI: 0.901–0.947) and poor functional outcomes at discharge (OR = 0.950, 95 % CI: 0.920–0.981) and at 3 months (OR = 0.913, 95 % CI: 0.878–0.950). Similarly, higher total bilirubin levels were also correlated with higher baseline NIHSS scores (OR = 1.038, 95 % CI: 1.022–1.055) and poor functional outcomes at discharge (OR = 1.021, 95 % CI: 1.001–1.042) and at 3 months (OR = 1.029, 95 % CI: 1.004–1.054). The risk of a poor 3-month prognosis in AIS patients increased with decreasing albumin levels at admission, independent of age, sex, and history of stroke (p < 0.05).

Conclusions

Decreased ALB and increased total bilirubin levels were associated with increased NIHSS scores at admission and poor prognosis at discharge and 3 months in AIS patients.