| Correlation between Systemic Inflammatory Parameter, Occurrence of Delayed Neurological Deficits and Outcome after Aneurysmal Subarachnoid Hemorrhage. | |
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MedLine Citation:
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PMID: 23208059 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: The role and impact of systemic inflammatory response after aneurysmal subarachnoid hemorrhage (SAH) remains to be elucidated. OBJECTIVE:: To assess the time course and correlation of systemic inflammatory parameters with outcome and occurrence of delayed ischemic neurological deficits (DIND) after SAH. METHODS:: Besides the baseline characteristics, daily interleukin (IL)-6, procalcitonin (PCT), C-reactive protein (CRP) levels, and leukocyte (Lc) counts were prospectively measured until day 14 after SAH. Occurrence of infectious complications and application of therapeutic hypothermia were assessed as confounding factors. Primary endpoint was the outcome after 3 months, assessed by Glasgow outcome scale (GOS); secondary endpoint was the occurrence of DIND. RESULTS:: During a 3-years period, a total of 138 patients were included. All inflammatory parameters measured where higher in patients with unfavorable outcome (GOS 1-3). After adjustment for confounding factors, elevated IL-6 and Lc counts remained significant risk factors for unfavorable outcome: Odds ratio for log IL-6 was 4.07, (95% confidence interval (CI) 1.18-14.03, p=0.026) and 1.24 (95% CI 1.06-1.46, p=0.008) for Lc counts. The analysis of the time course established that IL-6 was the only significantly elevated parameter in the early phase in patients with unfavorable outcome. Higher IL-6 levels in the early phase (day 3-7) were associated with occurrence of DIND. Adjusted odds ratio for log IL-6 was 4.03 (1.21-13.40, p=0.023). CONCLUSION:: Higher IL-6 levels are associated with worse clinical outcome and occurrence of DIND. As IL-6 levels were significantly elevated in the early phase, they might be a useful parameter to monitor. |
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Authors:
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Carl Muroi; Michael Hugelshofer; Martin Seule; Ilhan Tastan; Masayuki Fujioka; Kenichi Mishima; Emanuela Keller |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-30 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-12-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Switzerland 2Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Japan 3Department of Neurosurgery, Kantonsspital Aarau, Switzerland 4Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. |
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