Coagulation Profile after Spontaneous Intracerebral Hemorrhage: A Cohort Study

Background. Intracerebral hemorrhage (ICH) accounts for 10–20% of all strokes and is associated with high morbidity and mortality. Recent studies have identified serum biomarkers as a means to improve outcome prognostication in poor grade ICH patients. Poor prognosis of ICH patients and complex pathophysiology of the disease necessitate prognostic serum biomarkers to help guide treatment recommendations. Objective. The objective is to systematically review all biomarkers used to predict long-term functional outcome in patients with spontaneous intracerebral hemorrhage. Results. We identified 36 studies investigating the predictive utility of 50 discrete biomarkers. Data from 4865 ICH patients were reviewed. Inflammatory biomarkers (11/50) were most often studied, followed by oxidative (8/50), then neuron and astrocyte-specific (7/50). S100 calcium binding protein B, white blood cell count, and copeptin were the most often studied individual biomarkers. The prognostic utility of 23 biomarkers was analyzed using receiver operating characteristic curves. Area under the curve (AUC) values for all available biomarkers except neutrophil/lymphocyte ratio were acceptable. Twenty of the 23 biomarkers were characterized by at least one excellent AUC value. Vascular endothelial growth factor, glial fibrillary astrocyte protein, and S100 calcium binding protein B were characterized by outstanding AUC. Conclusions. We identified the inflammatory and neuron and astrocyte-specific biomarker categories as having the greatest number of significant individual biomarker predictors of long-term outcome. Further investigation utilizing cross-validation of prediction models in a second independent group and blinded assessment of outcomes for the predictive utility of biomarkers in patients with ICH is warranted.

show abstract

“…Thus, increased levels are expected to be associated with poor long-term functional outcomes. 25,39-43…”

Section: Discussionmentioning

confidence: 99%

“…However, thrombin, ROTEM, and TAT were not significantly associated with long-term outcome in this cohort. 39 It is possible that coagulation factors are related to platelet activation in the recovery of ICH.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Utility of Serum Biomarkers in Intracerebral Hemorrhage: A Systematic Review

Troiani

Ascanio

Rossitto

et al. 2021

Neurorehabil Neural Repair

View full text Add to dashboard Cite

show abstract

“…Patients with hematoma expansion had significantly longer baseline K and delta compared with nonexpanders, indicating that the former group had slower clot formation [30]. Other reports have also demonstrated greater baseline hypercoagulability in patients with ICH [31,32].…”

Section: Intracerebral Hemorrhagementioning

confidence: 90%

Assessment and management of coagulopathy in neurocritical care

et al. 2019

View full text Add to dashboard Cite

Normal coagulation is a balance between hemostatic and fibrinolytic processes, the loss of which may result in either excessive bleeding or intravascular thrombosis, which defines coagulopathy. Abnormalities in coagulation testing may also be considered evidence of coagulopathy, even in the absence of clinical sequelae of bleeding or thrombosis. There is limited data on the incidence of coagulopathy in neurocritical care units; however, it is commonly seen in critically ill patients with incidences ranging widely from 14% to 81% [1,2]. Coagulopathies may be acquired through a variety of conditions including trauma, organ failure and the use of medications, and may

show abstract

“…Further details on the cohort and exclusion criteria have been previously published. 1,2 Blood samples were drawn from a peripheral vein or arterial line at admission to hospital and 24 AE 2 hours after symptom onset. Samples were batch analyzed shortly after patient inclusion ended.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously shown that both conditions are associated with early hypercoagulation. 1,2 Histones have been demonstrated to promote thrombin generation. 3 In sepsis and trauma patients, studies have revealed an association between histone-DNA complexes and free histone levels and mortality or morbidity.…”

Section: Introductionmentioning

confidence: 99%