PURPOSE: Accurate early anticipation of long-term irreversible brain damage during the acute phase of patients with aneurysmal subarachnoid hemorrhage (aSAH) remains difficult. Using a combination of clinical scores together with brain injury-related biomarkers (H-FABP, NDKA, UFD1 and S100beta), this study aimed at developing a multiparameter prognostic panel to facilitate early outcome prediction following aSAH. METHODS: Blood samples of 141 aSAH patients from two separated cohorts (sets of 28 and 113 patients) were prospectively enrolled and analyzed with 14 months of delay. Patients were admitted within 48 h following aSAH onset. A venous blood sample was withdrawn within 12 h after admission. H-FABP, NDKA, UFD1, S100beta and troponin I levels were determined using classical immunoassays. The World Federation of Neurological Surgeons (WFNS) at admission and the Glasgow Outcome Score (GOS) at 6 months were evaluated. RESULTS: In the two cohorts, blood concentration of H-FABP, S100beta and troponin I at admission significantly predicted unfavorable outcome (GOS 1-2-3). A multivariate analysis identified a six-parameter panel, including WFNS, H-FABP, S100beta, troponin I, NDKA and UFD-1; when at least three of these parameters were simultaneously above cutoff values, prediction of unfavorable outcome reached around 70% sensitivity in both cohorts for 100% specificity. CONCLUSION: The use of this panel, including four brain injury-related proteins, one cardiac marker and a clinical score, could be a valuable tool to identify aSAH patients at risk of poor outcome.
PURPOSE: Accurate early anticipation of long-term irreversible brain damage during the acute phase of patients with aneurysmal subarachnoid hemorrhage (aSAH) remains difficult. Using a combination of clinical scores together with brain injury-related biomarkers (H-FABP, NDKA, UFD1 and S100beta), this study aimed at developing a multiparameter prognostic panel to facilitate early outcome prediction following aSAH. METHODS: Blood samples of 141 aSAH patients from two separated cohorts (sets of 28 and 113 patients) were prospectively enrolled and analyzed with 14 months of delay. Patients were admitted within 48 h following aSAH onset. A venous blood sample was withdrawn within 12 h after admission. H-FABP, NDKA, UFD1, S100beta and troponin I levels were determined using classical immunoassays. The World Federation of Neurological Surgeons (WFNS) at admission and the Glasgow Outcome Score (GOS) at 6 months were evaluated. RESULTS: In the two cohorts, blood concentration of H-FABP, S100beta and troponin I at admission significantly predicted unfavorable outcome (GOS 1-2-3). A multivariate analysis identified a six-parameter panel, including WFNS, H-FABP, S100beta, troponin I, NDKA and UFD-1; when at least three of these parameters were simultaneously above cutoff values, prediction of unfavorable outcome reached around 70% sensitivity in both cohorts for 100% specificity. CONCLUSION: The use of this panel, including four brain injury-related proteins, one cardiac marker and a clinical score, could be a valuable tool to identify aSAH patients at risk of poor outcome.
Authors: Michael T Wunderlich; Thorsten Hanhoff; Michael Goertler; Friedrich Spener; Jane F C Glatz; Claus-W Wallesch; Maurice M A L Pelsers Journal: J Neurol Date: 2005-04-18 Impact factor: 4.849
Authors: Ana R Pereira; Paola Sanchez-Peña; Alessandra Biondi; Nader Sourour; Anne L Boch; Chantal Colonne; Lise Lejean; Lamine Abdennour; Louis Puybasset Journal: Neurocrit Care Date: 2007 Impact factor: 3.210
Authors: Vivien H Lee; Bichun Ouyang; Sayona John; James J Conners; Rajeev Garg; Thomas P Bleck; Richard E Temes; Shawna Cutting; Shyam Prabhakaran Journal: Neurocrit Care Date: 2014-08 Impact factor: 3.210
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2011-01-04 Impact factor: 17.440
Authors: Blessing N R Jaja; Michael D Cusimano; Nima Etminan; Daniel Hanggi; David Hasan; Don Ilodigwe; Hector Lantigua; Peter Le Roux; Benjamin Lo; Ada Louffat-Olivares; Stephan Mayer; Andrew Molyneux; Audrey Quinn; Tom A Schweizer; Thomas Schenk; Julian Spears; Michael Todd; James Torner; Mervyn D I Vergouwen; George K C Wong; Jeff Singh; R Loch Macdonald Journal: Neurocrit Care Date: 2013-02 Impact factor: 3.210