ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1534381
The WBC/HDL Ratio Outperforms Other Lipid Profiles in Predicting Mortality Among Ischemic Stroke Patients: A Retrospective Cohort Study Using MIMIC-IV Data
Provisionally accepted
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To assess the prognostic value of lipid profiles and their ratios, particularly the white blood cell to high-density lipoprotein (WBC/HDL) ratio, for predicting 28-day and 1year all-cause mortality in ischemic stroke patients admitted to the ICU.A retrospective cohort study was conducted using the MIMIC-IV ICU database, including 2,894 ischemic stroke patients. Lipid profiles-including total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein-and derived ratios were analyzed. Associations with mortality were assessed using Cox proportional hazards models adjusted for demographic and clinical factors. Restricted cubic spline and Kaplan-Meier survival analyses were utilized to explore the relationship between the WBC/HDL ratio and mortality risk.Traditional lipid profiles and their ratios were not significantly associated with 28-day or 1-year mortality. Conversely, an elevated WBC/HDL ratio was independently associated with increased mortality risk at both 28 days (hazard ratio: 2.198; 95% confidence interval: 1.864-3.225) and 1 year (hazard ratio: 3.163; 95% confidence interval: 2.947-3.334).Restricted cubic spline analysis demonstrated a linear relationship between the WBC/HDL ratio and mortality risk, while Kaplan-Meier analyses indicated significantly poorer survival outcomes for patients with higher WBC/HDL ratios.The WBC/HDL ratio is a superior prognostic marker for mortality in ischemic stroke patients admitted to the ICU, outperforming traditional lipid profiles.Incorporating this measure into clinical practice may enhance early risk stratification and guide targeted interventions.
Keywords: Lipid profiles, White blood cell to HDL ratio, Stroke mortality, Inflammation, MIMIC-IV database
Received: 25 Nov 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Zou, Dong, Zhang, XIE, Zhang, Li, Dan, Liu and Mei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yumin Liu, Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
Bin Mei, Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.