Background: The impact of Total Bile Acids (TBA) level on clinical outcomes after
acute Intracerebral Hemorrhage (ICH) is still not understood.
Objective: We investigated whether admission TBA level is associated with hematoma volume,
stroke clinical severity, and 3-month outcomes in acute ICH patients.
Methods: 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.
Results: 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).
Conclusions: Higher admission TBA was associated with smaller hematoma volume and decreased
clinical severity, but not three month outcomes in patients with acute ICH.