The WBC/HDL ratio outperforms other lipid profiles in predicting mortality among ischemic stroke patients: a retrospective cohort study using MIMIC-IV data

作者：Li Juan Zou, Dong Sun, Lei Zhang, Yu Xie, Renwei Zhang, Huagang Li, Bitang Dan, Yumin Liu, Bin Mei · 发表于：Frontiers in Neurology · 年份：2025 · DOI：10.3389/fneur.2025.1534381 · 被引用次数：3 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Lipoproteins and Cardiovascular Health、Diabetes, Cardiovascular Risks, and Lipoproteins

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 1-year all-cause mortality in ischemic stroke patients admitted to the ICU. Methods: 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. Results: 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. Interpretation: The WBC/HDL ratio is a superior prognostic marker for mortality in ischemic stro...