Increased Serum Total Bile Acids can be Associated with a Small Hematoma Volume and Decreased Clinical Severity During Acute Intracerebral Hemorrhage

The impact of Total Bile Acids (TBA) level on clinical outcomes after acute Intracerebral Hemorrhage (ICH) is still not understood.We investigated whether admission TBA level is associated with hematoma volume, stroke clinical severity, and 3-month outcomes in acute ICH patients.A total of 335 ICH patients were prospectively enrolled. Patients were divided into four groups, according to the quartiles of serum TBA level at the time of admission. Three-month outcomes were evaluated by interviews with patients or their family members.The median hematoma volumes for the quartiles of TBA level (Q1 to Q4) were 12.0, 12.3, 10.0, and 6.7 mL (P<0.001) and the median National Institutes of Health Stroke Scale (NIHSS) scores were 8, 8, 6, and 5 (P=0.002), respectively. In the adjusted models, patients in the highest quartile (Q4) had smaller hematoma volumes (P=0.039) and lower NIHSS scores (P=0.037) than patients in Q1. At three months follow-up, there were 136 patients with poor outcomes (defined as having modified Rankin Scale scores≥3) and 46 cases of all-cause deaths. TBA level was not significantly associated with poor outcome nor all-cause death after adjusting for age, sex, hematoma volume, and baseline NIHSS(all P-trend≥0.380).Higher admission TBA was associated with smaller hematoma volume and decreased clinical severity, but not three month outcomes in patients with acute ICH.