Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?

Elhechmi, Youssef Zied; Hassouna, Malek; Cherif, Mohamed Ali; Kaddour, Rym; Sedghiani, Ines; Jerbi, Z

doi:10.1016/j.jstrokecerebrovasdis.2016.11.129

Cited by 20 publications

(18 citation statements)

References 14 publications

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“…Higher plasma CRP at hospital admission is consistently associated with hematoma growth and poor ICH outcome. 185,186 Hepcidin, an acute phase reactant and key iron regulator is elevated after ICH and associated with poor three-month outcome. 187 Elevations in serum ferritin, an acute phase response protein that regulates iron-storage, are also associated with poor outcome in ICH patients.…”

Section: Cellular and Molecular Biomarkers Of Systemic Inflammation Amentioning

confidence: 99%

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Saand

Chen

et al. 2019

J Cereb Blood Flow Metab

131

132

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Growing evidences suggest that stroke is a systemic disease affecting many organ systems beyond the brain. Stroke-related systemic inflammatory response and immune dysregulations may play an important role in brain injury, recovery, and stroke outcome. The two main phenomena in stroke-related peripheral immune dysregulations are systemic inflammation and post-stroke immunosuppression. There is emerging evidence suggesting that the spleen contracts following ischemic stroke, activates peripheral immune response and this may further potentiate brain injury. Whether similar brain–immune crosstalk occurs in hemorrhagic strokes such as intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) is not established. In this review, we systematically examined animal and human evidence to date on peripheral immune responses associated with hemorrhagic strokes. Specifically, we reviewed the impact of clinical systemic inflammatory response syndrome (SIRS), inflammation- and immune-associated biomarkers, the brain–spleen interaction, and cellular mediators of peripheral immune responses to ICH and SAH including regulatory T cells (Tregs). While there is growing data suggesting that peripheral immune dysregulation following hemorrhagic strokes may be important in brain injury pathogenesis and outcome, details of this brain-immune system cross-talk remain insufficiently understood. This is an important unmet scientific need that may lead to novel therapeutic strategies in this highly morbid condition.

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Section: Cellular and Molecular Biomarkers Of Systemic Inflammation Amentioning

confidence: 99%

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Saand

Chen

et al. 2019

J Cereb Blood Flow Metab

131

132

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“…Higher levels of CRP were independently associated with higher mortality and poor functional outcome at 30 days. From a clinical perspective, it is noteworthy to mention that serial CRP measurements during the acute ICH stages could provide different predictive utility: admission CRP values were only weakly related to mortality and did not predict functional status, CRP at 24 h was a better predictor of mortality and unfavorable outcome, and predictability improved further with the obtained CRP levels at 48 or 72 h that was stronger for mortality than for functional recovery ( 27 , 79 , 80 ).…”

Section: Crp Stratification In Acute Ich: Short and Long-term Prognosmentioning

confidence: 99%

Monomeric C-Reactive Protein and Cerebral Hemorrhage: From Bench to Bedside

Napoli¹,

Slevin

Popa‐Wagner

et al. 2018

Front. Immunol.

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C-reactive protein (CRP) is an important mediator and a hallmark of the acute-phase response to inflammation. High-sensitivity assays that accurately measure levels of CRP have been recommended for use in risk assessment in ischemic stroke patients. Elevation of CRP during the acute-phase response in intracerebral hemorrhage (ICH) is also associated with the outcomes such as death and vascular complications. However, no association has been found with the increased risk of ICH. The aim of this review is to synthesize the published literature on the associations of CRP with acute ICH both as a risk biomarker and predictor of short- and long-term outcomes as well as its role as a pathogenic determinant. We believe before any clinical utility, a critical appraisal of the strengths and deficiencies of the accumulated evidence is required both to evaluate the current state of knowledge and to improve the design of future clinical studies.

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“…[13][14][15] In the studies conducted on this subject, the mean GOS score was found to be 1 point in cases with GCS score of 7 and below, while the GOS score was found in the range of 4-5 points in cases with GCS score above 7. [16][17][18][19] In addition, it has been shown that the advanced patient age and comorbidity such as vascular pathology, coagulation disorder and diabetes mellitus adversely affects the prognosis in patients with chronic subdural hematoma. [20] The most commonly preferred surgical treatment method in patients with chronic subdural hematoma is the burr-hole evacuation technique.…”

Section: Discussionmentioning

confidence: 99%

Can routine biochemical tests be a short-term prognostic biomarker in patients operated for chronic subdural hematoma?

Yüksel¹,

Öğden²,

Bulut³

et al. 2020

roneuro

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Objectives: The effect of routine blood biochemistry parameters on the short-term prognosis of patients with chronic subdural hematoma (CSDH) has not been evaluated in literature before. In this study, it was aimed to establish markers for determination of short-term prognosis using data of patients who were operated for CSDH. Methods: During admission to hospital, data of patients including age, sex, antiaggregan and/or anticoagulant drugs usage, comorbidity, Glasgow Coma Scale (GCS) and Glasgow Outcome Scale scores were evaluated. Location and thickness of CSDH were recorded using brain CT or MR images. Blood leukocyte, neutrophil, lymphocyte, eosinophil, basophil, platelet count results, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio results, activated prothrombin time and INR values, serum glucose, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, sodium, potassium, blood urea nitrogen and creatinine level values were also recorded. Patients were divided into two groups according to CSDH located “unilaterally (n=19)” and “bilaterally (n=12)”. In addition, patients with unilateral CSDH were divided into two groups as CSDH located at the "right hemisphere (n=6)” and "left hemisphere (n=13)". Results: It was concluded that short-term prognosis of patients with unilateral or bilateral CSDH was similar. Correlation analysis showed no correlation between short-term prognosis and demographic, clinical and laboratory findings. However, Likelihood Ratio test revealed that GCS score could be a biomarker in order to predict short-term prognosis of these patients, albeit weak (X2=6.138, p=0.046). Conclusion: It was thought that GCS scores could be effective in predicting short-term prognosis in patients with CSDH but routine biochemistry laboratory parameters could not predict short-term prognosis of these patients.

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Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?

Cited by 20 publications

References 14 publications

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

Monomeric C-Reactive Protein and Cerebral Hemorrhage: From Bench to Bedside

Can routine biochemical tests be a short-term prognostic biomarker in patients operated for chronic subdural hematoma?

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