Association between systemic inflammatory response syndrome and hematoma expansion in intracerebral hemorrhage

Abstract

Background. Hematoma expansion (HE) is a relatively common complication after intracerebral hemorrhage.Objectives. To explore the association between systemic inflammatory response syndrome (SIRS) and HE in patients with intracerebral hemorrhage (ICH). Materials and methods.From June 2013 to October 2020, the sociodemographic data and clinical data of 780 ICH patients were collected. The logistic regression analysis with odd ratios (ORs) and 95% confidence intervals (95% CIs) was performed to analyze the risk factors for HE in patients with ICH.Results. Hematoma expansion occurred in 151 (19.36%) patients with ICH. Significant differences were presented between SIRS and HE (OR = 2.549, 95% CI: [1.497; 4.342], p = 0.0006). After adjusting the covariates, a further analysis showed that the respiratory rate >20 beats/min (OR = 3.436, 95% CI: [1.981; 5.960], p < 0.0001), white blood cell (WBC) > 12×10 9 /L or WBC ≤ 4×10 9 /L (OR = 2.489, 95% CI: [1.494; 4. 149], p = 0.0005) increased the risk for HE in ICH patients. Our study also found that the significant differences between HE and non-HE patients in proportion of patients with history of diabetes mellitus, basal ganglia hemorrhage, hypothalamus hemorrhage and fasting blood glucose (all p < 0.05) (OR = 2.076, 95% CI: [1.274; 3.381], p = 0.0034), basal ganglia hemorrhage (OR = 2.512, 95% CI: [1.496; 4.218], p = 0.0005), hypothalamus hemorrhage (OR = 2. 121, 95% CI: [1.007; 4.466], p = 0.0479), high C-reactive protein (CRP) (OR = 1.013, 95% CI: [1.002; 1.024], p = 0.0184), and hyperglycemia (OR = 1.099, 95% CI: [1.026; 1. 178], p = 0.0074) were associated with an increased risk of HE in ICH patients. Conclusions.The SIRS is closely associated with the risk of HE. Respiratory rate >20 beats/min and WBC count >12(10 9 /L) or ≤4(10 9 /L) increased the risk for HE in ICH patients. These findings can help to achieve the early prevention of HE and improve the prognosis of ICH patients.

More severe initial manifestations and worse short-term functional outcome of intracerebral hemorrhage in the plateau than in the plain

“…Fourthly, hematoma expansion may also contribute to the poor functional outcome significantly, 47,48 which may be associated with the acute hypertensive response, blood pressure variability and inflammation. 49,50 Finally, in line with previous research, ethnicity influenced the outcome of on ICH. 51,52 The implications of ethnicity encompass various factors, including genetic polymorphisms, 53 differences in healthcare processes 54 and variations in health insurance coverage.…”

A Prospective Cohort Study of Elevated Serum NLRP1 Levels to Prognosticate Neurological Outcome After Acute Intracerebral Hemorrhage at a Single Academic Institution

“… 43 , 44 The systemic inflammatory response can be activated after acute ICH. 34 , 35 Thus, serum NLRP may be secreted by peripheral cells. Injuries in both the central and peripheral systems are highly related to poor prognosis of ICH.…”

“…First, there was a substantial enhancement in serum NLRP1 levels after acute ICH, with the highest levels at days 1 and 3, as well as compared to healthy controls, higher levels were observed during ICH is a common cerebrovascular disorder characterized by inflammation of both the central and peripheral systems. [34][35][36][37] However, a comprehensive understanding of the pathophysiological mechanisms underlying ICH-related…”