INTRODUCTION AND GOAL Substance P, a neuropeptide of the tachykinin family, is involved in the neuroinflammation of different diseases of the central nervous system. To our knowledge, there is no published data on the level of circulating substance P levels in the prognosis of patients with spontaneous intracerebral hemorrhage (ICH). Therefore, the objectives of this observational and prospective study were to determine whether serum substance P levels in ICH patients were associated with early mortality and whether could be used in the mortality prognostic. MATERIAL AND METHODS We included patients with severe primary supratentorial ICH (defined as Glasgow Coma Scale < 9) from 6 Intensive Care Units of Spanish hospitals. We determined serum substance P levels at the time of severe ICH diagnosis, at fourth and at eighth day. Thirty-day mortality was considered the end-point study. FINDINGS Non-surviving (n=53) compared to surviving ICH patients (n=64) showed higher serum substance P levels at day 1 (p<0.001), day 4 (p<0.001) and day 8 (p<0.001). The area under the curve for 30-day mortality prediction by serum substance P levels was of 79% (95% CI = 70-86%; p<0.001). Kaplan-Meier analysis showed a higher 30-day mortality in patients with serum substance P levels>503 pg/mL (Hazard ratio=14.7; 95% CI=6.88-31.55; p<0.001). Multiple logistic regression analysis showed an association between serum substance P levels and 30-day mortality (Odds Ratio=1.006; 95% CI=1.002-1.010; p=0.004) controlling for ICH score, midline shift, glycemia, early evacuation of ICH. CONCLUSIONS Thus, the novel aspects our study include that serum substance P levels in severe primary ICH patients were higher in non-surviving than in surviving patients, that serum substance P levels were associated with early mortality controlling for other variables, and that serum substance P levels could be used as biomarkers of prognosis.

中文翻译：

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自发性脑出血患者的血清P物质水平和早期死亡率。

简介和目标P物质是速激肽家族的一种神经肽，参与中枢神经系统各种疾病的神经炎症。据我们所知，尚无关于自发性脑出血（ICH）患者预后中循环物质P水平的公开数据。因此，这项观察性和前瞻性研究的目的是确定ICH患者的血清P物质水平是否与早期死亡率相关，以及是否可用于死亡率预后。材料与方法我们纳入了来自西班牙医院的6个重症监护病房的严重原发性幕上ICH（定义为格拉斯哥昏迷量表<9）的患者。我们在严重ICH诊断时，第四天和第八天确定了血清P物质水平。30天死亡率被认为是终点研究。结果与未存活的ICH患者（n = 64）相比，未存活（n = 53）在第1天（p <0.001），第4天（p <0.001）和第8天（p <0.001）显示较高的血清P物质水平。通过血清P物质水平预测30天死亡率的曲线下面积为79％（95％CI = 70-86％； p <0.001）。Kaplan-Meier分析显示，血清P物质含量> 503 pg / mL的患者，其30天死亡率更高（危险比= 14.7； 95％CI = 6.88-31.55； p <0.001）。多元逻辑回归分析显示，血清物质P水平与30天死亡率之间的相关性（赔率= 1.006； 95％CI = 1.002-1.010； p = 0.004）可控制ICH评分，中线移位，血糖和ICH的早期撤离。结论因此，