Journal Article

A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

Vutskits, Laszlo, Robin, Xavier, Turck, Natacha, Sanchez-Pena, Paola, Mueller, Markus, Gex-Fabry, Marianne, Lisacek, Frédérique, Puybasset, Louis, Hainard, Alexandre, Fouda, Catherine, Sanchez, Jean-Charles, Bassem, Hadiji

2010

Overview

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 S100β), 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 A venous blood sample was withdrawn within 12 h after admission.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, S100β 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, S100β 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, S100β, 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.

• Publisher: Springer-Verlag,Springer,Springer Nature B.V
• Subject: Acute Disease / Aged / Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy / Anesthesiology / Aneurysms / Bioinformatics / Biological and medical sciences / Biomarkers / Brain / Brain damage / Brain Damage, Chronic - epidemiology / Brain Damage, Chronic - etiology / Carrier Proteins - metabolism / Critical Care Medicine / Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care / Emergency Medicine / Enzyme-Linked Immunosorbent Assay / Fatty acids / Fatty Acids - metabolism / Female / France / Heart - physiology / Hematoma / Hemorrhage / Humans / Hydrocephalus / Injuries / Intensive / Intensive care / Intensive care medicine / Kinases / Male / Medical prognosis / Medical sciences / Medicine / Medicine & Public Health / Middle Aged / Nerve Growth Factors - blood / Neurosurgical Procedures / NM23 Nucleoside Diphosphate Kinases - metabolism / Original / Outcome Assessment (Health Care) / Pain Medicine / Patient outcomes / Patients / Pediatrics / Pneumology/Respiratory System / Predictive Value of Tests / Prognosis / Prospective Studies / Proteins / Proteins - metabolism / S100 Calcium Binding Protein beta Subunit / S100 Proteins - blood / Stroke (Disease) / Subarachnoid hemorrhage / Subarachnoid Hemorrhage - complications / Subarachnoid Hemorrhage - diagnosis / Subarachnoid Hemorrhage - surgery / Surgery / Traumatic brain injury / Troponin I - blood