Early Diagnosis of Delayed Cerebral Ischemia: Possible Relevance for Inflammatory Biomarkers in Routine Clinical Practice?

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Early Diagnosis of Delayed Cerebral Ischemia: Possible Relevance for Inflammatory Biomarkers in Routine Clinical Practice?

World Neurosurg. 2017 May 13;:

Authors: Chamling B, Gross S, Stoffel-Wagner B, Schubert GA, Clusmann H, Coburn M, Höllig A

Abstract
BACKGROUND: Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is one of the main causes of neurological deterioration. However, it frequently evades timely detection. Early identification and effective reversal may improve the clinical outcome. In this prospective study, we evaluate several serum inflammatory markers after aSAH with regard to the occurrence of DCI.
METHODS: On days 1, 4, 7, 10 and 14 after SAH leucocyte count, C-reactive protein, interleukin-6, E-selectin, matrix metallopeptidase 9, intercellular adhesion molecule 1 and leukemia inhibitory factor were assessed in patients´ serum samples. Using a Cox regression model (SPSS 21.0), associations of baseline parameters, maximum and delta (maximum minus baseline) values with occurrence of DCI were evaluated.
RESULTS: Considering the assessed parameters, leucocyte count (high baseline and delta values) matches most closely with occurrence of DCI. While baseline levels of C-reactive protein also are associated with occurrence of DCI, neither maximum (only on a borderline level) nor delta levels do so.
CONCLUSIONS: Our data analysis identified leucocyte count as the parameter most likely associated with occurrence of DCI. However, due to its lack of specificity leucocyte count it cannot be used as a biomarker. As hypothesized earlier, the results indicate a possible involvement of the inflammatory reaction after aSAH in the pathomechanism of DCI.

PMID: 28512045 [PubMed - as supplied by publisher]

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