Objective
To value the usefulness of brain injury biomarkers (BIB) and inflammatory markers
(IM) to predict mortality in spontaneous intracranial hemorrhage patients (SIH).
Material and Methods
BIB (D Dimer (DD), BNP and CRP) were determined at admission, 1, 2, 3 and 7th day;
IM at admission and 7th day. Descriptive analysis % and Median (minimal/ maximum).
Independent samples T-student to compare means (p < 0.05). A binary logistic multivariate
regression analysis was performed (95% CI OR).
Results
103 patients with SIH. 66% were men. Age 61.8 (± 12.7). Overall Mortallity 37%. ICU
stay 7 days (1-55). Glasgow Coma Scale 12 (3-15). SIH 20.18 cc volume (1-252).
The univariate correlation between of BIB and MI with mortality in Table 1. In mutivariate
analysis: protective factors were BNP at admission (OR 1.1, 95% CI 1.1-1.2 (p 0.02)),
DD at 7th day (OR 1.1, 95% CI 1.1-1.3 (p 0.009)) and Prealbumin at 7th day (OR 0.9,
95% CI 0.8-0.9 (p 0.03)).
Table 1
Relationship brain injury biomarkers and inflammatory markers with mortality; Median
± SD. BIB: Brain injury biomarkers; IM: Inflammatory markers; BNP: Brain natriuretic
peptide; DD: D Dimer.
BIB and IM
Dead
Alive
P
BNP (pg/ml)
Admission
223,5 ± 318,46
82.41 ± 95,55
0,001
24 h
175,96 ± 202,08
87.84 ± 77,19
0,002
48 h
142.32 ± 156,01
94.12 ± 82,66
0,04
DD (µg/L)
48 h
1915,8 ± 1631,5
883,7 ± 1368,6
0, 001
72 h
2525,27 ± 2142,47
1051.92 ± 1254,15
0,000
7th d
3677.07 ± 2224,72
2150.9 ± 1820,42
0,005
Leukocytosis
Admission
12037,5 ± 4806,8
10241,8 ± 3624,2
0,03
Albumin (g/dl)
Admission
3,4 ± 0,52
3,7 ± 0,55
0,01
Prealbúmin (mg/dl)
Admission 7th d
18,97 ± 6,78 16,74 ± 7,28
22.30 ± 5,36 21,22 ± 8,03
0,008 0,02
Conclusions
BNP at admission, 24 h and 48 h and DD as late marker at 48 h, 72 h and 7th day were
correlated with mortality in patients with SIH. IM correlated with mortality: leukocytosis,
albumin and prealbumin at admission and prealbumin, ferritin and haptoglobin at 7th
day.
Multivariate analysis found significance for increased risk of death BNP at admission
and DD at 7th day; and protective factor was Prealbumin at 7th day.