Audrey C Leasure1, Lindsey R Kuohn1, Kevin N Vanent1, Matthew B Bevers2, W Taylor Kimberly3, Thorsten Steiner4,5, Stephan A Mayer6, Charles C Matouk7, Lauren H Sansing1, Guido J Falcone1, Kevin N Sheth1. 1. Department of Neurology (A.C.L., L.R.K., K.N.V., L.H.S., G.J.F., K.N.S.), Yale University School of Medicine, New Haven, CT. 2. Divisions of Stroke, Cerebrovascular and Critical Care Neurology, Brigham and Women's Hospital, Boston, MA (M.B.B.). 3. Division of Neurocritical Care, Department of Neurology, Massachusetts General Hospital, Boston (W.T.K.). 4. Department of Neurology, Klinikum Frankfurt Höchst, Germany (T.S.). 5. Department of Neurology, Heidelberg University Hospital, Germany (T.S.). 6. Departments of Neurology and Neurosurgery, New York Medical College, Westchester Medical Center Health Network, Valhalla (S.A.M.). 7. Department of Neurosurgery (C.C.M.), Yale University School of Medicine, New Haven, CT.
Abstract
BACKGROUND AND OBJECTIVES: IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH). METHODS: We performed an exploratory analysis of the recombinant activated FAST trial (Factor VII for Acute ICH). Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin Scale. In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema volumes. RESULTS: Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (modified Rankin Scale, 4-6; per additional 1 ng/L, odds ratio, 1.30 [95% CI, 1.04-1.63]; P=0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex, and ICH location, and this association was modified by location (multivariable interaction, P=0.002), with a stronger association seen in lobar (β, 12.51 [95% CI, 6.47-18.55], P<0.001) versus nonlobar (β 5.32 [95% CI, 3.36-7.28], P<0.001) location. IL-6 was associated with perihematomal edema volume after adjustment for age, sex, ICH volume, and ICH location (β 1.22 [95% CI, 0.15-2.29], P=0.03). Treatment group was not associated with IL-6 levels or outcome. CONCLUSIONS: In the FAST trial population, higher admission IL-6 levels were associated with worse 90-day functional outcome and larger ICH and perihematomal edema volumes.
BACKGROUND AND OBJECTIVES: IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH). METHODS: We performed an exploratory analysis of the recombinant activated FAST trial (Factor VII for Acute ICH). Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin Scale. In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema volumes. RESULTS: Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (modified Rankin Scale, 4-6; per additional 1 ng/L, odds ratio, 1.30 [95% CI, 1.04-1.63]; P=0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex, and ICH location, and this association was modified by location (multivariable interaction, P=0.002), with a stronger association seen in lobar (β, 12.51 [95% CI, 6.47-18.55], P<0.001) versus nonlobar (β 5.32 [95% CI, 3.36-7.28], P<0.001) location. IL-6 was associated with perihematomal edema volume after adjustment for age, sex, ICH volume, and ICH location (β 1.22 [95% CI, 0.15-2.29], P=0.03). Treatment group was not associated with IL-6 levels or outcome. CONCLUSIONS: In the FAST trial population, higher admission IL-6 levels were associated with worse 90-day functional outcome and larger ICH and perihematomal edema volumes.
Entities:
Keywords:
brain injury; cerebral hemorrhage; cytokine; edema; odds ratio
Authors: J H Tapia-Pérez; D Karagianis; R Zilke; V Koufuglou; I Bondar; T Schneider Journal: Clin Neurol Neurosurg Date: 2016-08-31 Impact factor: 1.876
Authors: Stephan A Mayer; Nikolai C Brun; Kamilla Begtrup; Joseph Broderick; Stephen Davis; Michael N Diringer; Brett E Skolnick; Thorsten Steiner Journal: N Engl J Med Date: 2008-05-15 Impact factor: 91.245
Authors: Keenan A Walker; Melinda C Power; Ron C Hoogeveen; Aaron R Folsom; Christie M Ballantyne; David S Knopman; B Gwen Windham; Elizabeth Selvin; Clifford R Jack; Rebecca F Gottesman Journal: Stroke Date: 2017-11-03 Impact factor: 7.914
Authors: Ernest H Choy; Fabrizio De Benedetti; Tsutomu Takeuchi; Misato Hashizume; Markus R John; Tadamitsu Kishimoto Journal: Nat Rev Rheumatol Date: 2020-04-23 Impact factor: 20.543