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The Impact of Nonsteroidal Anti-inflammatory Drugs on Inflammatory Response After Aneurysmal Subarachnoid Hemorrhage

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Abstract

Background

The degree of inflammatory response with cytokine release is associated with poor outcomes after aneurysmal subarachnoid hemorrhage (SAH). Previously, we reported on an association between systemic IL-6 levels and clinical outcome in patients with aneurysmal SAH. The intention was to assess the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen on the inflammatory response after SAH.

Methods

Our method involved exploratory analysis of data and samples collected within a previous study. In 138 patients with SAH, systemic interleukin (IL-6) and c-reactive protein (CRP) were measured daily up to day 14 after SAH. The correlations among the cumulatively applied amount of NSAIDs, inflammatory parameters, and clinical outcome were calculated.

Results

An inverse correlation between cumulatively applied NSAIDs and both IL-6 and CRP levels was found (r = −0.437, p < 0.001 and r = −0.369, p < 0.001 respectively). Multivariable linear regression analysis showed a cumulative amount of NSAIDs to be independently predictive for systemic IL-6 and CRP levels. The cumulative amount of NSAIDs reduced the odds for unfavorable outcome, defined as Glasgow outcome scale 1–3.

Conclusions

The results indicate a potential beneficial effect of NSAIDs in patients with SAH in terms of ameliorating inflammatory response, which might have an impact on outcome.

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Acknowledgments

We thank Mrs. Margaritha Winther for her help in the data collection and secretarial work.

Conflict of interest

Carl Muroi, Michael Hugelshofer, Martin Seule, and Emanuela Keller declare that they have no conflict of interest.

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Authors and Affiliations

  1. Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

    Carl Muroi, Michael Hugelshofer, Martin Seule & Emanuela Keller

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Carl Muroi

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  1. Carl Muroi
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  2. Michael Hugelshofer
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  3. Martin Seule
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  4. Emanuela Keller
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Correspondence to Carl Muroi.

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Muroi, C., Hugelshofer, M., Seule, M. et al. The Impact of Nonsteroidal Anti-inflammatory Drugs on Inflammatory Response After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 20, 240–246 (2014). https://doi.org/10.1007/s12028-013-9930-2

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