Markus Lenski1, Volker Huge2, Josef Briegel2, Jörg-Christian Tonn3, Christian Schichor3, Niklas Thon3. 1. Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany. Electronic address: markus.lenski@med.uni-muenchen.de. 2. Department of Anesthesiology, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany. 3. Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
Abstract
OBJECTIVE: The aim of the study was to investigate the diagnostic potential of interleukin 6 (IL-6) and other soluble biomarkers in serum and cerebrospinal fluid (CSF) for early diagnosis of cerebral vasospasm (cVSSAH) and external ventricular drain-associated ventriculitis (VCSAH) and to separate these conditions from aneurysmal subarachnoid hemorrhage (aSAH) without further complication (SAHw/o/c). METHODS: The concentrations of serum biomarkers and markers in the CSF were collected in 63 consecutive patients with aSAH and external ventricular drainage. Arithmetical means and standard deviations, area under the curve (AUC), cutoff values (C-OFF), sensitivity (SE), and specificity (SP) were calculated for markers and their correlation with SAHw/o/c, cVSSAH, and VCSAH. RESULTS: Clinical courses included 27 patients with cVSSAH, 17 with VCSAH, and 19 with SAHw/o/c. Mean ± standard deviationCSFIL-6 values were 7588 ± 4580 pg/mL at onset of VCSAH and 4102 ± 4970 pg/mL for cVSSAH and higher than 234 ± 239 pg/mL in SAHw/o/c (P < 0.001). CSFIL-6 showed excellent diagnostic potential for differing between VCSAH and SAHw/o/c (AUC, 1.00; C-OFF, 707; SE, 100%; SP, 100%), and a moderate diagnostic potential for differing VCSAH from cVSSAH (AUC, 0.757; C-OFF, 3100 pg/Ml; SE, 86.7%; SP, 70.6%). The concentration of CSFIL-6 within the cVSSAH group was significantly increased compared with SAHw/o/c (AUC, 0.937; C-OFF, 530 pg/mL; SE, 87.5%; SP, 91.7%). CONCLUSIONS: CSFIL-6 is increased after aSAH in patients with cVSSAH or VCSAH. Patients with a CSFIL-6 level higher than a C-OFF of 3100 pg/mL have an increased likelihood for VCSAH; patients with CSFIL-6 levels between 530 and 3100 pg/mL have an increased posttest probability for cVSSAH.
OBJECTIVE: The aim of the study was to investigate the diagnostic potential of interleukin 6 (IL-6) and other soluble biomarkers in serum and cerebrospinal fluid (CSF) for early diagnosis of cerebral vasospasm (cVSSAH) and external ventricular drain-associated ventriculitis (VCSAH) and to separate these conditions from aneurysmal subarachnoid hemorrhage (aSAH) without further complication (SAHw/o/c). METHODS: The concentrations of serum biomarkers and markers in the CSF were collected in 63 consecutive patients with aSAH and external ventricular drainage. Arithmetical means and standard deviations, area under the curve (AUC), cutoff values (C-OFF), sensitivity (SE), and specificity (SP) were calculated for markers and their correlation with SAHw/o/c, cVSSAH, and VCSAH. RESULTS: Clinical courses included 27 patients with cVSSAH, 17 with VCSAH, and 19 with SAHw/o/c. Mean ± standard deviationCSFIL-6 values were 7588 ± 4580 pg/mL at onset of VCSAH and 4102 ± 4970 pg/mL for cVSSAH and higher than 234 ± 239 pg/mL in SAHw/o/c (P < 0.001). CSFIL-6 showed excellent diagnostic potential for differing between VCSAH and SAHw/o/c (AUC, 1.00; C-OFF, 707; SE, 100%; SP, 100%), and a moderate diagnostic potential for differing VCSAH from cVSSAH (AUC, 0.757; C-OFF, 3100 pg/Ml; SE, 86.7%; SP, 70.6%). The concentration of CSFIL-6 within the cVSSAH group was significantly increased compared with SAHw/o/c (AUC, 0.937; C-OFF, 530 pg/mL; SE, 87.5%; SP, 91.7%). CONCLUSIONS: CSFIL-6 is increased after aSAH in patients with cVSSAH or VCSAH. Patients with a CSFIL-6 level higher than a C-OFF of 3100 pg/mL have an increased likelihood for VCSAH; patients with CSFIL-6 levels between 530 and 3100 pg/mL have an increased posttest probability for cVSSAH.
Authors: Wendy C Ziai; Adrian R Parry-Jones; Carol B Thompson; Lauren H Sansing; Michael T Mullen; Santosh B Murthy; Andrew Mould; Saman Nekoovaght-Tak; Daniel F Hanley Journal: Biomolecules Date: 2021-07-30
Authors: Anke Höllig; Birgit Stoffel-Wagner; Hans Clusmann; Michael Veldeman; Gerrit A Schubert; Mark Coburn Journal: Front Neurol Date: 2017-12-22 Impact factor: 4.003
Authors: Susan Giorgi-Coll; María J Marín; Olajumoke Sule; Peter J Hutchinson; Keri L H Carpenter Journal: Mikrochim Acta Date: 2019-12-04 Impact factor: 5.833
Authors: Audrey C Leasure; Lindsey R Kuohn; Kevin N Vanent; Matthew B Bevers; W Taylor Kimberly; Thorsten Steiner; Stephan A Mayer; Charles C Matouk; Lauren H Sansing; Guido J Falcone; Kevin N Sheth Journal: Stroke Date: 2021-03-08 Impact factor: 7.914