Intensive Care Medicine

, Volume 33, Issue 6, pp 1000–1006 | Cite as

Microalbuminuria is a prognostic predictor in aneurysmal subarachnoid hemorrhage

  • Yoshiaki Terao
  • Masafumi Takada
  • Takahiro Tanabe
  • Yuko Ando
  • Makoto Fukusaki
  • Koji Sumikawa
Original

Abstract

Objective

To determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH).

Design

Prospective and observational clinical study.

Setting

Multidisciplinary intensive care unit.

Patients

Fifty-one consecutive patients who underwent aneurysm clipping or endovascular surgery after SAH; 8 patients who underwent surgical clipping for unruptured intracerebral aneurysm served as control.

Intervention

None.

Measurements and Results

General clinical and neurological data were recorded on admission. Urine was collected preoperatively and daily for up to 7 days postoperatively for measuring the urinary microalbumin/creatinine ratio. The Glasgow Coma Scale (GCS) score was also determined on admission and daily for up to 7 days after operation. Neurological outcome was assessed using the Glasgow Outcome Scale (GOS) at 3 months after stroke.

The prevalence rates of microalbuminuria were 74.5% in SAH and 37.5% in the control. Among the 51 patients, 25 had unfavorable neurological outcome (GOS 1–3). The areas under the receiver operator characteristic curves showed that the highest urinary microalbumin/creatinine ratio and the lowest GCS score during the first 8 days were the significant predictors of unfavorable neurological outcome. The threshold value, sensitivity, specificity, and likelihood ratio for the highest urinary microalbumin/creatinine ratio were 200 mg/g, 60% [95% confidence interval (CI) 41–79], 96% (95% CI 88–100), and 15.6 (95% CI 9.1–26.7), respectively.

Conclusions

This study confirms a high prevalence of microalbuminuria in the SAH patients, and it suggests that the highest urinary microalbumin/creatinine ratio > 200 mg/g during the first 8 days is a significant predictor of unfavorable neurological outcome.

Keywords

Microalbuminuria Urinary albumin creatinine ratio Subarachnoid hemorrhage Systemic inflammatory response Neurological outcome Glasgow Coma Scale 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Yoshiaki Terao
    • 1
  • Masafumi Takada
    • 1
  • Takahiro Tanabe
    • 1
  • Yuko Ando
    • 1
  • Makoto Fukusaki
    • 1
  • Koji Sumikawa
    • 2
  1. 1.Department of AnesthesiaNagasaki Rosai HospitalSaseboJapan
  2. 2.Division of Anesthesiology, Department of Translational Medical SciencesNagasaki University School of MedicineNagasakiJapan

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