Leonardo Lorente1, María M Martín2, Antonia Pérez-Cejas3, Agustín F González-Rivero3, Rafael Sabatel4, Luis Ramos-Gómez5, Mónica Argueso6, Jordi Solé-Violán7, Juan J Cáceres8, Alejandro Jiménez9, Victor García-Marín10. 1. Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., 38320, La Laguna, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com. 2. Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n., 38010, Santa Cruz de Tenerife, Spain. 3. Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., 38320, La Laguna, Santa Cruz de Tenerife, Spain. 4. Department of Radiology, Hospital Universitario de Canarias, Ofra, s/n., 38320, La Laguna, Santa Cruz de Tenerife, Spain. 5. Intensive Care Unit, Hospital General La Palma, Buenavista de Arriba s/n, 38713, Breña Alta, La Palma, Spain. 6. Intensive Care Unit, Hospital Clínico Universitario de Valencia, Avda. Blasco Ibáñez no. 17-19, 46004, Valencia, Spain. 7. Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Barranco de la Ballena s/n., 35010, Las Palmas de Gran Canaria, Spain. 8. Intensive Care Unit, Hospital Insular, Plaza Dr. Pasteur s/n., 35016, Las Palmas de Gran Canaria, Spain. 9. Research Unit, Hospital Universitario de Canarias, Ofra s/n., 38320, La Laguna, Santa Cruz de Tenerife, Spain. 10. Department of Neurosurgery, Hospital Universitario de Canarias, Ofra, s/n., 38320, La Laguna, Santa Cruz de Tenerife, Spain.
Abstract
OBJECTIVE: Oxidation contributes to secondary brain injury after spontaneous intracerebral haemorrhage (SIH). One study found lower levels of total antioxidant capacity (TAC) in the blood in patients with SIH than in healthy subjects. However, there are no data on blood TAC levels and survival in patients with SIH. Therefore, the objective of our study was to determine if an association exists between serum TAC levels and mortality in patients with SIH. METHODS: We included patients with severe supratentorial SIH. We considered severe when Glasgow Coma Scale (GCS) < 9. Patients from 6 Spanish hospitals were included in this observational and prospective study. Serum TAC levels at days 1, 4 and 8 of SIH were determined. Thirty-day mortality was our end-point study. RESULTS: Non-surviving patients compared with surviving patients showed higher serum TAC levels at day 1 (p < 0.001), 4 (p < 0.001) and 8 (p = 0.001). An area under the curve was found for the prediction of 30-day mortality by serum TAC levels of 0.92 (95% CI = 0.85-96%; p < 0.001). Multiple logistic regression analysis showed an association of serum TAC levels with 30-day mortality (odds ratio = 16.513; 95% CI = 2.548-107.015; p = 0.003) controlling for midline shift, glycemia, early evacuation of SIH, intracerebral haemorrhage (ICH) score, age and volume of SIH. CONCLUSIONS: The new findings of this study are that serum TAC levels are higher in non-surviving than in surviving patients, and that they are associated with mortality and could be used to predict mortality.
OBJECTIVE: Oxidation contributes to secondary brain injury after spontaneous intracerebral haemorrhage (SIH). One study found lower levels of total antioxidant capacity (TAC) in the blood in patients with SIH than in healthy subjects. However, there are no data on blood TAC levels and survival in patients with SIH. Therefore, the objective of our study was to determine if an association exists between serum TAC levels and mortality in patients with SIH. METHODS: We included patients with severe supratentorial SIH. We considered severe when Glasgow Coma Scale (GCS) < 9. Patients from 6 Spanish hospitals were included in this observational and prospective study. Serum TAC levels at days 1, 4 and 8 of SIH were determined. Thirty-day mortality was our end-point study. RESULTS: Non-surviving patients compared with surviving patients showed higher serum TAC levels at day 1 (p < 0.001), 4 (p < 0.001) and 8 (p = 0.001). An area under the curve was found for the prediction of 30-day mortality by serum TAC levels of 0.92 (95% CI = 0.85-96%; p < 0.001). Multiple logistic regression analysis showed an association of serum TAC levels with 30-day mortality (odds ratio = 16.513; 95% CI = 2.548-107.015; p = 0.003) controlling for midline shift, glycemia, early evacuation of SIH, intracerebral haemorrhage (ICH) score, age and volume of SIH. CONCLUSIONS: The new findings of this study are that serum TAC levels are higher in non-surviving than in surviving patients, and that they are associated with mortality and could be used to predict mortality.
Entities:
Keywords:
Apoptosis; Mortality; Patients; Spontaneous intracerebral haemorrhage; Total antioxidant capacity