Brain injury biomarkers and inflammatory markerslike pronostic factors on mortality in patients with spontaneous intracranial hemorrhage (medical-adults intensive care)

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.

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.