Erdem Güresir1, Christoph Coch2, Rolf Fimmers3, Inja Ilic4, Alexis Hadjiathanasiou4, Tamara Kern4, Simon Brandecker4, Ági Güresir4, Markus Velten5, Hartmut Vatter4, Patrick Schuss4. 1. Department of Neurosurgery, University Hospital Bonn, Bonn, Germany. Electronic address: Erdem.Gueresir@ukbonn.de. 2. Clinical Study Core Unit SZB and Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Germany. 3. Clinical Study Core Unit SZB and Institute for Medical Biometry, Informatic and Epidemiology, University of Bonn, Germany. 4. Department of Neurosurgery, University Hospital Bonn, Bonn, Germany. 5. Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
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.
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 SAHpatients. These findings might help to identify a subgroup of good grade SAHpatients 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: Lorena M Schenk; Matthias Schneider; Christian Bode; Erdem Güresir; Christoph Junghanns; Marcus Müller; Christian Putensen; Hartmut Vatter; Julian Zimmermann; Patrick Schuss; Felix Lehmann Journal: Front Neurol Date: 2021-02-25 Impact factor: 4.003