Association between different bilirubin subtypes and clinical outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy: A retrospective cohort study

The association between serum bilirubin levels and clinical outcomes in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT) remains elusive, warranting further investigation. This retrospective cohort study encompassed 787 AIS patients who underwent MT between January 2018 and December 2022. Baseline serum levels of direct bilirubin (DBIL), indirect bilirubin (IBIL), and total bilirubin (TBIL) were documented. Adverse clinical outcomes comprised any intracranial hemorrhage (ICH) within 72 h, symptomatic intracranial hemorrhage, stroke-associated pneumonia (SAP), early neurological deterioration, 3-month poor functional outcome, and 3-month mortality. The findings revealed that DBIL and TBIL levels exhibited positive correlations with the incidence of SAP, ICH, and 3-month poor functional outcome. IBIL levels demonstrated a positive association with ICH occurrence. Notably, DBIL tends to exhibite superior predictive value for adverse outcomes compared to IBIL and TBIL. In conclusion, baseline serum bilirubin could as a potential biomarker for adverse clinical outcomes in AIS patients undergoing MT, pending further validation.