Intensive Care Medicine

, Volume 36, Issue 1, pp 107–115 | Cite as

A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

  • Natacha Turck
  • Laszlo Vutskits
  • Paola Sanchez-Pena
  • Xavier Robin
  • Alexandre Hainard
  • Marianne Gex-Fabry
  • Catherine Fouda
  • Hadiji Bassem
  • Markus Mueller
  • Frédérique Lisacek
  • Louis Puybasset
  • Jean-Charles Sanchez
Original

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 A venous blood sample was withdrawn within 12 h after admission.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

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)

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Copyright information

© Copyright jointly hold by Springer and ESICM 2009

Authors and Affiliations

  • Natacha Turck
    • 1
  • Laszlo Vutskits
    • 2
  • Paola Sanchez-Pena
    • 3
  • Xavier Robin
    • 1
    • 4
  • Alexandre Hainard
    • 1
  • Marianne Gex-Fabry
    • 5
  • Catherine Fouda
    • 1
  • Hadiji Bassem
    • 3
  • Markus Mueller
    • 4
  • Frédérique Lisacek
    • 4
  • Louis Puybasset
    • 3
  • Jean-Charles Sanchez
    • 1
  1. 1.Biomedical Proteomics Research Group, Department of Structural Biology and BioinformaticsMedical University CentreGeneva 4Switzerland
  2. 2.Department of Anesthesiology, Pharmacology and Intensive CareUniversity Hospital of GenevaGeneva 14Switzerland
  3. 3.Department of Anesthesiology and Critical CarePitié-Salpêtrière Teaching HospitalParisFrance
  4. 4.Swiss Institute of BioinformaticsMedical University CentreGeneva 4Switzerland
  5. 5.Department of PsychiatryUniversity Hospital of GenevaChêne-BourgSwitzerland

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