Intensive Care Medicine

, Volume 36, Issue 1, pp 107–115

A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

Authors

    • Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University Centre
  • Laszlo Vutskits
    • Department of Anesthesiology, Pharmacology and Intensive CareUniversity Hospital of Geneva
  • Paola Sanchez-Pena
    • Department of Anesthesiology and Critical CarePitié-Salpêtrière Teaching Hospital
  • Xavier Robin
    • Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University Centre
    • Swiss Institute of BioinformaticsMedical University Centre
  • Alexandre Hainard
    • Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University Centre
  • Marianne Gex-Fabry
    • Department of PsychiatryUniversity Hospital of Geneva
  • Catherine Fouda
    • Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University Centre
  • Hadiji Bassem
    • Department of Anesthesiology and Critical CarePitié-Salpêtrière Teaching Hospital
  • Markus Mueller
    • Swiss Institute of BioinformaticsMedical University Centre
  • Frédérique Lisacek
    • Swiss Institute of BioinformaticsMedical University Centre
  • Louis Puybasset
    • Department of Anesthesiology and Critical CarePitié-Salpêtrière Teaching Hospital
  • Jean-Charles Sanchez
    • Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University Centre
Original

DOI: 10.1007/s00134-009-1641-y

Cite this article as:
Turck, N., Vutskits, L., Sanchez-Pena, P. et al. Intensive Care Med (2010) 36: 107. doi:10.1007/s00134-009-1641-y

Abstract

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 A venous blood sample was withdrawn within 12 h after admission.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

Keywords

Aneurysmal subarachnoid hemorrhageH-FABPNDKAS100βPrognosis

Abbreviations

H-FABP

Heart-fatty acid binding protein

NDKA

Nucleoside diphosphate kinase A

UFD-1

Ubiquitin fusion degradation protein-1

aSAH

Aneurysmal subarachnoid hemorrhage

SE

Sensitivity

SP

Specificity

Supplementary material

134_2009_1641_MOESM1_ESM.doc (90 kb)
Online data supplements 1–5 (DOC 90 kb)

Copyright information

© Copyright jointly hold by Springer and ESICM 2009