Distinct prognostic value of aspartate-to-alanine aminotransferase ratio (AAR) in traumatic brain injury versus hemorrhagic stroke: a cohort study of 1,069 patients - Scorecard - MDSpire

Distinct prognostic value of aspartate-to-alanine aminotransferase ratio (AAR) in traumatic brain injury versus hemorrhagic stroke: a cohort study of 1,069 patients

  • By

  • Dilmurat Gheyret

  • Xiaotao Gao

  • Ziwei Zhou

  • Lei Li

  • Jinchao Wang

  • Xu Zhang

  • Haoran Jia

  • Shu Zhang

  • Mirzat Turhon

  • Maimaitili Aisha

  • Cong Wang

  • Yuhan Li

  • Yingsheng Wei

  • Shuo An

  • Jian Sun

  • Jianning Zhang

  • Hengjie Yuan

  • Ye Tian

  • June 4, 2026

  • 0 min

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Clinical Scorecard: Prognostic Implications of Aspartate-to-Alanine Aminotransferase Ratio (AAR) in Traumatic Brain Injury Compared to Hemorrhagic Stroke: Analysis of a Cohort of 1,069 Patients

At a Glance

CategoryDetail
ConditionTraumatic Brain Injury (TBI), Intracerebral Hemorrhage (ICH), Aneurysmal Subarachnoid Hemorrhage (aSAH)
Key MechanismsLiver-brain axis, systemic metabolic stress, mitochondrial dysfunction
Target PopulationPatients aged 18 years or older with TBI, ICH, or aSAH
Care SettingNeurosurgery department, Tianjin Medical University General Hospital, China

Key Highlights

  • Elevated AAR is a robust independent predictor of poor outcomes in TBI (adjusted OR 2.15).
  • AAR shows no significant prognostic value in ICH or aSAH.
  • A significant dose–response relationship exists between AAR and unfavorable outcomes.
  • Prognostic effect of AAR in TBI escalates with injury severity (Severe TBI: adjusted OR 5.38).
  • 39.3% of patients experienced unfavorable outcomes at discharge.

Guideline-Based Recommendations

Diagnosis

  • Use AAR as a prognostic marker in TBI.

Management

  • Monitor AAR levels in TBI patients to assess prognosis.

Monitoring & Follow-up

  • Evaluate AAR in conjunction with other clinical parameters.

Risks

  • Caution against using AAR as a prognostic marker in ICH and aSAH.

Patient & Prescribing Data

1,069 consecutive patients with TBI, ICH, or aSAH.

AAR may reflect systemic metabolic stress in TBI.

Clinical Best Practices

  • Consider AAR in the context of overall clinical assessment in TBI.
  • Avoid reliance on AAR for prognostication in hemorrhagic strokes.

Related Resources & Content

Original Source(s)

Distinct prognostic value of aspartate-to-alanine aminotransferase ratio (AAR) in traumatic brain injury versus hemorrhagic stroke: a cohort study of 1,069 patients

  • by Dilmurat Gheyret, Xiaotao Gao, Ziwei Zhou, Lei Li, Jinchao Wang, Xu Zhang, Haoran Jia, Shu Zhang, Mirzat Turhon, Maimaitili Aisha, Cong Wang, Yuhan Li, Yingsheng Wei, Shuo An, Jian Sun, Jianning Zhang, Hengjie Yuan, Ye Tian

  • June 4, 2026

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