Cerebrospinal fluid red blood cells and total protein are associated with clinical outcome in spontaneous subarachnoid hemorrhage.

Autor: Berek K; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Lindner A; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Kindl P; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Di Pauli F; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Schiefecker AJ; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Pfausler B; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Helbok R; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; Department of Neurology, Johannes Kepler University, Linz, Austria., Deisenhammer F; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Beer R; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Rass V; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Hegen H; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2025 Jan; Vol. 32 (1), pp. e16456. Date of Electronic Publication: 2024 Oct 30.
DOI: 10.1111/ene.16456
Abstrakt: Background and Purpose: Prognostication in patients with spontaneous subarachnoid hemorrhage (SAH) can be challenging. The aim of this study was to assess whether cerebrospinal fluid (CSF) red blood cell (RBC) count and total protein (TP) concentration are associated with SAH prognosis.
Methods: Patients with SAH treated at the neurological intensive care unit (ICU) in Innsbruck were included in this real-world, observational study. Longitudinal CSF samples were collected as part of routine diagnostics. RBC count and CSF TP at the time of admission (RBC first , TP first ), in Week 1 (RBC Days1-7 , TP Days1-7 ), Week 2 (RBC Days8-14 , TP Days8-14 ), and Week 3 or thereafter (RBC Day>14 , TP Day>14 ), the highest detected value (RBC highest , TP highest ), as well as the RBC count adjusted for disease duration (RBC adjusted ) were assessed. Primary outcomes were good functional outcome after 3 months, defined as modified Rankin scale score ≤2 and ICU survival.
Results: A total of 183 SAH patients with a female predominance (69%), a median (interquartile range [IQR]) age of 60 (50-70) years and median (IQR) Hunt and Hess score of 4 (3-5) were included. Multivariable analyses revealed that lower values of RBC first , RBC adjusted , RBC highest , TP first and TP highest were associated with good functional outcome and hospital survival. Lower TP concentrations in Weeks 1, 2 and 3 were associated with good functional outcome, and in Weeks 1 and 2 with ICU survival. Early RBC measurements (Week 1) were associated with good functional outcome and ICU survival.
Conclusions: Low CSF RBC counts and TP concentrations were associated with good functional outcome and ICU survival in a real-world cohort of SAH patients requiring external ventricular drainage.
(© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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