Background

Intracerebral hemorrhage (ICH) is associated with high mortality, morbidity, and recurrence. Studies have reported the accuracy of several blood biomarkers in predicting clinical outcomes; however, their independent contribution in prediction remains to be established.

Aim

To investigate the incremental accuracy in predicting clinical outcomes in patients with ICH in a north Indian population using blood-based biomarkers.

Methods

In this study, a total of 250 ICH cases were recruited within 72 hours of onset. Baseline clinical and CT scan measurement were recorded. Homocysteine (HCY), C-reactive protein (CRP), matrix metalloproteinase-9 (MMP9), E-selectin (SELE), and P-selectin (SELP) levels were measured through ELISA. Telephonic follow-up was done by using mRS scale at three months.

Results

The mean age of cohort was 54.9 (SD±12.8) years with 64.8% patients being male. A total of 109 (43.6%) deaths were observed over three months follow-up. Area under the receiver operating characteristics curve-(AUROC) for 90-day mortality were 0.55 (HCY), 0.62 (CRP), 0.57 (MMP9), 0.60 (SELE) and 0.53 (SELP) and for poor outcome at 90-day (mRS: 3-6) were 0.60 (HCY), 0.62 (CRP), 0.54 (MMP9), 0.67 (SELE) and 0.54 (SELP). In multivariable model including age, ICH volume, IVH and GCS at admission, serum SELE (p=0.004) significant for poor outcome with improved AUROC (0.86) and HCY (p=0.04), CRP (p=0.003) & MMP9 (p=0.02) for mortality with least Akaike's Information Criterion-(AIC) (1060.5).

Conclusions

Our findings suggest that the serum SELE is a significant predictor of poor outcome and HCY, CRP & MMP9 for Mortality in patients with ICH in the north Indian population.

中文翻译：

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用于预测脑出血后临床结果的血液生物标志物的增量准确性

背景

脑出血（ICH）与高死亡率，高发病率和复发相关。研究报告了几种血液生物标志物预测临床结果的准确性。但是，它们在预测中的独立贡献仍有待确定。

目标

为了调查使用血液生物标记物预测印度北部人群ICH患者临床结果的准确性的提高。

方法

在这项研究中，发病后72小时内共招募了250例ICH病例。记录基线临床和CT扫描测量值。通过ELISA测定了同型半胱氨酸（HCY），C反应蛋白（CRP），基质金属蛋白酶9（MMP9），E选择素（SELE）和P选择素（SELP）的水平。在三个月时使用mRS量表进行电话随访。

结果

队列的平均年龄为54.9（SD±12.8）岁，男性为64.8％。在三个月的随访中，共观察到109例（43.6％）死亡。90天死亡率的接收器工作特征曲线下面积（AUROC）为0.55（HCY），0.62（CRP），0.57（MMP9），0.60（SELE）和0.53（SELP），以及90天死亡率差（ mRS：3-6）分别为0.60（HCY），0.62（CRP），0.54（MMP9），0.67（SELE）和0.54（SELP）。在包括年龄，ICH量，IVH和入院时GCS在内的多变量模型中，血清SELE（p = 0.004）对于不良结局具有显着意义，AUROC（0.86）和HCY（p = 0.04），CRP（p = 0.003）和MMP9（p死亡率至少为Akaike信息标准（AIC）（1060.5）的== 0.02。

结论

我们的研究结果表明，血清SELE是印度北部ICH患者预后不良以及HCY，CRP和MMP9死亡率的重要预测指标。