Increased serum total bilirubin-albumin ratio was associated with bilirubin encephalopathy in neonates

Wang, Yan; Sheng, Guang-Yao; Shi, Lina; Cheng, Xiuyong

doi:10.1042/bsr20192152

Cited by 13 publications

(17 citation statements)

References 18 publications

(19 reference statements)

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“…Researchers have pointed that elevated bilirubin could lead to irreversible damage to the brains and neurons, especially the increased indirect bilirubin with strong toxicity. 30 , 31 And the bilirubin-albumin ratio level was related to the bilirubin encephalopathy, which could be a potential predictor in neonates’ patients. The imbalance of oxidation and antioxidation is associated with varieties of inflammatory conditions.…”

Section: Discussionmentioning

confidence: 94%

Perioperative Transfusion is Related to the Length of Hospital Stays in Primary Liver Cancer Patients

Qi¹,

Qian²,

Zhu³

et al. 2021

CMAR

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Purpose Blood loss may be corrected with red blood cell transfusion, but may ultimately contribute to negative impacts. This study was a retrospective analysis to assess the impact of perioperative blood transfusion on hospital stay days in liver cancer patients. Methods We retrospectively examined data from patients with primary liver cancer who underwent curative resection. Patients were divided into perioperative blood transfusion (PBT) and non-PBT groups. Data were given as means and SDs for continuous variables and as counts and percentage for categorical variables. The correlation between blood transfusion and hospital stay days was analyzed by Fisher’s exact test. Multivariable logistic regression analyses were used to identify independent predictors of length of hospital stays. Results Totally 206/1031 patients (20.3%) were given perioperative transfusion. The mean length of hospital stay was 17.8 days in PBT and 13.9 days in non-PBT groups. Our multivariable logistic regression showed transfusion, total bilirubin, indirect bilirubin, and the ratio of albumin to bilirubin were all indicators of the length of hospital stay days. Perioperative transfusion was also associated with prolonged length of hospital stays (95% CI: 0.395–0.811, p = 0.002). Transfusion also affected intrinsic coagulation factors (activated partial thromboplastin time, fibrinogen, platelet), inflammatory index (neutrocyte to lymphocyte ratio, monocyte), albumin and bilirubin levels. Conclusion Perioperative transfusion of blood was associated with a significantly increased length of hospital stays probably via changing intrinsic coagulation and inflammatory factors and bilirubin levels in plasma.

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Section: Discussionmentioning

confidence: 94%

Perioperative Transfusion is Related to the Length of Hospital Stays in Primary Liver Cancer Patients

Qi¹,

Qian²,

Zhu³

et al. 2021

CMAR

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“…This increase in amplitude is contrary to the brain maturation process, suggesting a correlation with bilirubin toxicity. Previous studies have reported B/A value as a predictor for bilirubin encephalopathy (29,30), with higher total B/A ratio increasing the risk of bilirubin encephalopathy by 23% (odds ratio: 1.23, 95% CI: 1.16-2.48). Our clinical prediction model, which added graphic indicators of aEEG to B/A value, significantly improved the predictive ability.…”

Section: Discussionmentioning

confidence: 95%

Amplitude-integrated electroencephalography improves the predictive ability of acute bilirubin encephalopathy

Chang¹,

Zheng²,

Ju³

et al. 2021

Transl Pediatr

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Background: To establish a clinical prediction model of acute bilirubin encephalopathy (ABE) using amplitude-integrated electroencephalography (aEEG). Methods: A total of 114 neonatal hyperbilirubinemia patients in the Beijing Chaoyang hospital from August 2015 to October 2018 were enrolled in this study. There were 62 (54.38%) males, and the age of patients undergoing aEEG examination was 2-23 days, with an average of 7.61±4.08 days. Participant clinical information, peak bilirubin value, albumin value, hyperbilirubinemia, and the graphic indicators of aEEG were extracted from medical records, and ABE was diagnosed according to a bilirubin-induced neurological dysfunction (BIND) score >0. Multivariable logistic regression was used to establish a clinical prediction model of ABE. Furthermore, decision curve analysis (DCA) was performed to evaluate the model's predictive value. Results: According to the BIND score, there were a total of 23 (20.18%) ABE cases. The multivariable logistic regression analysis showed that the value of bilirubin/albumin (B/A), presence of hyperbilirubinemia risk factors, number of sleep-wake cycling (SWC) within 3 hours, widest bandwidth, duration of SWC, and type of SWC were significantly associated with ABE. A clinical prediction model was developed as: p=ex/ (1+ex), X=0.278+0.713*B/A+2.602*with risk factors (with risk factors equals 1) − 1.500*SWC number within 3 hours + 0.219*the widest bandwidth-0.065*the duration of one SWC + 1.491* SWC (mature SWC equals 0, immature SWC equals 1). The area under the curve (AUC) was 0.85 [95% confidence interval (CI): 0.75-0.94], which was significantly higher than the AUC only based on conventional clinical information of B/A (AUC: 0.58, 95% CI: 0.45-0.72). The DCA also showed good predictive ability compared to B/A. Conclusions: A clinical prediction model can be established based on the patients' B/A, presence of risk factors for hyperbilirubinemia, number of SWC within 3 hours, widest bandwidth, duration of 1 SWC, and the type of SWC. It has good predictive ability and may improve the diagnostic accuracy of ABE.

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“…Several studies have shown that the B/A ratio is correlated with the BE risk [5-7, 14, 15, 19]. B/A ratio was inconsistently monitored in our pBE patients and was only evaluated for this study.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy

et al. 2021

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Introduction: The aim of this study is to clarify bilirubin parameters and its treatment in preterm infants with bilirubin encephalopathy (pBE). Methods: We asked the responders to an earlier nationwide Japanese survey on pBE to provide additional information. pBE was diagnosed based on the criteria used in the nationwide survey. We collected data on serum total bilirubin (TB), direct bilirubin (DB), albumin, and unbound bilirubin (UB) levels during the first 8 weeks of life, and on phototherapy and exchange transfusion treatments. Results: We obtained clinical data from 75 patients with pBE from 58 hospitals (response rate of 59%), who were born between 2002 and 2016. The average peak TB level was 12.6 mg/dL (215 μmol/L), and the average age at peak attainment was 19.7 days after birth. Albumin level was <2.5 g/dL in 44 patients, and the peak DB level was ≥2 mg/dL (34.2 μmol/L) in 20 patients. The average peak bilirubin/albumin (B/A) (mg/g) ratio was 3.8 (molar ratio of 0.475), and the average age at peak attainment was 18.6 days. The average peak UB level was 0.67 μg/dL (11.5 nmol/L). The median duration of phototherapy was 6 days, and the median day of the last session was 12. The peak TB level occurred after the last day of phototherapy in 30 of the 61 patients available for comparison. Conclusions: Most patients with pBE lacked marked elevations in serum TB levels and the B/A ratio, the peaks of which were sometimes delayed to >4 weeks after birth.

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Increased serum total bilirubin-albumin ratio was associated with bilirubin encephalopathy in neonates

Cited by 13 publications

References 18 publications

Perioperative Transfusion is Related to the Length of Hospital Stays in Primary Liver Cancer Patients

Perioperative Transfusion is Related to the Length of Hospital Stays in Primary Liver Cancer Patients

Amplitude-integrated electroencephalography improves the predictive ability of acute bilirubin encephalopathy

Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy

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