A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

Article Article scientifique Article A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage eng 2010 author Turck Natacha 632628 author Vutskits Laszlo 109383 author Sanchez-Pena Paola author Robin Xavier Arnaud 551454 author Hainard Alexandre 0009-0006-7403-3261 635700 author Gex-Fabry Marianne 592985 author Fouda Catherine 506123 author Bassem Hadiji author Mueller Markus 683174 author Lisacek Frédérique 0000-0002-0948-4537 639315 author Puybasset Louis author Sanchez Jean-Charles 0000-0002-8733-5932 24399 107-115 10.1007/s00134-009-1641-y 19760205 0342-4642 http://www.springerlink.com/content/u88j56772g2276u3/fulltext.pdf 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 S100beta), 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 A venous blood sample was withdrawn within 12 h after admission.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, S100beta 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, S100beta 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, S100beta, 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. Acute Disease Aged Brain Damage, Chronic/epidemiology/etiology Carrier Proteins/metabolism Enzyme-Linked Immunosorbent Assay Fatty Acids/metabolism Female France Heart/physiology Humans Male Middle Aged NM23 Nucleoside Diphosphate Kinases/metabolism Nerve Growth Factors/blood Neurosurgical Procedures Outcome Assessment (Health Care) Predictive Value of Tests Prognosis Prospective Studies Proteins/metabolism S100 Proteins/blood Subarachnoid Hemorrhage/complications/diagnosis/surgery Troponin I/blood Dewey 576 Dewey 615 Dewey 616.8 Dewey 616.89 Open Access - Licence nationale Springer 31 Section des sciences pharmaceutiques 17 53 Département de neurosciences fondamentales 21A 136 Département de biologie structurale et bioinformatique 21E 60 Département de psychiatrie 225 false 543 Anesthésie et neurosciences 883 369 Biomarqueurs 635 112 Progéniteurs neuronaux 141 Intensive care medicine 36 1 a675c3ab-4cbf-4fcf-97ce-fe24e3e8cf78 Article (Published version) Public file1.pdf 262338 application/pdf openAccess Faculté des sciences / Section des sciences pharmaceutiques Faculté de médecine / Section de médecine fondamentale / Département de neurosciences fondamentales Faculté de médecine / Section de médecine fondamentale / Département de biologie structurale et bioinformatique Faculté de médecine / Section de médecine clinique / Département de psychiatrie

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A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage	Intensive care medicine			2010	1,118	513

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Mueller, Markus