Original

Intensive Care Medicine

, Volume 36, Issue 1, pp 107-115

First online:

A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

  • Natacha TurckAffiliated withBiomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre Email author 
  • , Laszlo VutskitsAffiliated withDepartment of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva
  • , Paola Sanchez-PenaAffiliated withDepartment of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital
  • , Xavier RobinAffiliated withBiomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University CentreSwiss Institute of Bioinformatics, Medical University Centre
  • , Alexandre HainardAffiliated withBiomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre
  • , Marianne Gex-FabryAffiliated withDepartment of Psychiatry, University Hospital of Geneva
  • , Catherine FoudaAffiliated withBiomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre
  • , Hadiji BassemAffiliated withDepartment of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital
  • , Markus MuellerAffiliated withSwiss Institute of Bioinformatics, Medical University Centre
    • , Frédérique LisacekAffiliated withSwiss Institute of Bioinformatics, Medical University Centre
    • , Louis PuybassetAffiliated withDepartment of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital
    • , Jean-Charles SanchezAffiliated withBiomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

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 hemorrhage H-FABP NDKA S100β Prognosis