Initial inflammatory response is an independent predictor of unfavorable outcome in patients with good-grade aneurysmal subarachnoid hemorrhage.

Abstract

INTRODUCTION:

Purpose of the present study was to determine if routine biochemical markers of acute phase response are associated with unfavorable outcome in patients with good-grade aneurysmal SAH.

METHODS:

231 patients admitted with aneurysmal SAH and WFNS grade I - II were included in the present study. C-reactive protein (CRP) and procalcitonin (PCT) were measured within 24 h of admission. Outcome was assessed according to the modified Rankin Scale (mRS) after 6 months and stratified into favorable (mRS 0-2) vs. unfavorable (mRS 3-6).

RESULTS:

The multivariate regression analysis revealed "elevated baseline CRP" (p = .001, OR 3.2, 95% CI 1.6-6.6), "elevated baseline PCT" (p = .004, OR 26.0, 95% CI 2.9-235.5), "male gender" (p = .02, OR 2.3, 95% CI 1.1-4.8), and "age ≥ 65 years" (p = .009, OR 2.7, 95% CI 1.3-5.8) as a model for the prediction of unfavorable outcome in patients with good-grade SAH.

CONCLUSION:

An initial inflammatory response could be a possible explanation for poor outcome in good-grade SAH patients. These findings might help to identify a subgroup of good grade SAH patients who are at greater risk for unfavorable outcome early during treatment course/at baseline, and who could benefit most from potential anti-inflammatory therapy.

• Authors: Erdem Güresir, Christoph Coch, Rolf Fimmers, Inja Ilic, Alexis Hadjiathanasiou, Tamara Kern, Simon Brandecker, Ági Güresir, Markus Velten, Hartmut Vatter, Patrick Schuss
• Journal: Journal of critical care (J Crit Care) Vol. 60 Pg. 45-49 (12 2020) ISSN: 1557-8615 [Electronic] United States
• PMID: 32739759 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Procalcitonin
• C-Reactive Protein

Topics

• Adult
• Age Factors
• Aged
• Aneurysm, Ruptured (complications)
• Biomarkers (blood)
• C-Reactive Protein (analysis)
• Female
• Humans
• Inflammation (blood)
• Intracranial Aneurysm (complications)
• Male
• Middle Aged
• Multivariate Analysis
• Procalcitonin (blood)
• Prognosis
• ROC Curve
• Retrospective Studies
• Risk Factors
• Subarachnoid Hemorrhage (blood, etiology, therapy)
• Treatment Outcome