ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1595387
This article is part of the Research TopicCholesterol, inflammation and immunityView all 8 articles
Reduced Residual Cholesterol is Associated with Increased Mortality Risk in Patients with Aneurysmal Subarachnoid Hemorrhage: a retrospective study
Provisionally accepted
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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Background: Residual cholesterol has been confirmed to be related to the stroke incidence and stroke prognosis. There is no study exploring the relationship between residual cholesterol and the mortality of aneurysmal subarachnoid hemorrhage (aSAH). This study investigated the association between residual cholesterol and the mortality of aSAH.Restricted cubic spline was used to show the relationship between residual cholesterol and the mortality of aSAH. Univariate and multivariate logistic regression were used to find independent risk factors for mortality.Independent risk factors in the multivariate logistic regression were combined to develop a predictive model for mortality. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of residual cholesterol and the developed predictive model.Results: 20.0% of included aSAH patients suffered 30-day mortality. Total cholesterol (p=0.121), low-density lipoprotein cholesterol (p=0.143), and triglyceride (p=0.254) did not show significant difference between survivors and nonsurvivors, while high-density lipoprotein cholesterol (p=0.021) was higher in non-survivors. Residual cholesterol (p<0.001) was significantly lower among non-survivors. Multiple logistic regression identified seven significant risk factors for the mortality of aSAH including Glasgow Coma Scale (GCS) (p<0.001), mFisher (p=0.032), white blood cell (p=0.004), glucose (p=0.008), residual cholesterol (p=0.047), delayed cerebral ischemia (p<0.001), surgical options (p<0.001). A predictive model for the mortality of aSAH was developed by combining these seven significant factors. The area under the ROC (AUC) of the predictive model and residual cholesterol was 0.911 and 0.603.Residual cholesterol is negatively related to the mortality of aSAH. Evaluating residual cholesterol is helpful in risk stratification of aSAH patients.
Keywords: Residual cholesterol, lipid profile, Subarachnoid Hemorrhage, Intracranial Aneurysm, Mortality
Received: 23 Apr 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Zeng, Wang and Xu. 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: Jianguo Xu, Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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