Admission Emergency Department Point-of-care Biomarkers for Prediction of Early Mortality in Spontaneous Intracerebral Hemorrhage

Abstract

Background/Aim: Spontaneous intracerebral hemorrhage (sICH) has a significant morbidity and mortality, despite representing a non-dominant hemorrhagic stroke. The aim of the study was to assess the impact of the emergency department (ED) point-of-care (POC) biomarkers on early mortality in sICH patients. Patients and Methods: Demographic data, medical history and admission clinical parameters from adult patients with imaging-based sICH diagnosis were collected retrospectively, upon their ED presentation over a period of 18 months. ED-based POC analyzers were used for blood biomarkers [complete blood count, C reactive protein (CRP), glycemia, hepatic and renal function, D-dimer and cardiac troponin I]. Derived inflammatory indexes were calculated. Mortality endpoints were collected (on day 7 and at discharge). Results: Of the 219 included patients, mortality rates reached 30.14% on day

Association between high serum blood glucose lymphocyte ratio and all-cause mortality in non-traumatic cerebral hemorrhage: a retrospective analysis of the MIMIC-IV database

“…Constructing a column-line graph could enhance the predictive accuracy of preoperative central lymph node metastasis in these patients. In the realm of research pertaining to cerebral hemorrhage, prior researchers have established a correlation between the neutrophil-to-lymphocyte ratio (NLR) and blood glucose level (BGL), indicating an independent association between the two variables ( 8 , 9 ). Consequently, it can be inferred that the intricate interplay of various pathological mechanisms potentially influences the progression of inflammatory response and hyperglycemia, thereby exacerbating secondary brain damage.…”

“…Furthermore, patients with severe cerebral hemorrhage have demonstrated signs of immune cell activation and abnormal host reactions ( 6 , 7 ). Moreover, various systemic inflammatory biomarkers, such as the neutrophil-lymphocyte ratio (NLR) ( 8 ), platelet-lymphocyte ratio (PLR) ( 9 ), and lymphocyte-monocyte ratio (LMR) ( 10 ), have been linked to critical cerebrovascular disease and unfavorable prognosis in patients. The presence of immune cell deficiency and dysfunction is widely recognized as significant contributors to secondary infections and unfavorable prognosis in critically ill patients.…”

Korelasi antara Skor ICH C-Reactive Protein, D-Dimer terhadap Luaran Pasien Perdarahan Intraserebral

“…Bahkan ketiga parameter inflamasi lainnya yang dianalisis pada studi tersebut (homosistein, TNF-α, dan VEGF) juga tidak menunjukkan korelasi yang bermakna terhadap lama rawatan ICU. 13 Sebagai marka inflamasi fase-akut, efektivitas dari CRP dalam mengestimasi mortalitas maupun lama masa rawatan ICU dilaporkan memiliki tingkat prediksi yang sangat bervariasi antar studi, dengan satu studi menyatakan adanya hubungan yang nyata antara CRP dengan nilai tinggi dan prognosis yang lebih buruk, dan sebaliknya pada studi lain. Studi ini sendiri menyatakan CRP tidak memiliki potensi prediktif terhadap lama masa rawatan CRP, meskipun hasil tersebut harus divalidasi lebih lanjut dengan studi lainnya dalam bentuk analisis sistematis atau bahkan kalkulasi metaanalisis.…”