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A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage

Turck, Natacha ; Vutskits, Laszlo ; Sanchez-Pena, Paola ; Robin, Xavier ; Hainard, Alexandre ; Gex-Fabry, Marianne ; Fouda, Catherine ; Bassem, Hadiji ; Mueller, Markus ; Lisacek, Frédérique ; Puybasset, Louis ; Sanchez, Jean-Charles

In: Intensive Care Medicine, 2010, vol. 36, no. 1, p. 107-115

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    Titre
    • A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage
    Auteur
    • Turck, Natacha. Biomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre, DBSB/CMU, Rue Michel Servet, 1, 1211, Geneva 4, Switzerland
    • Vutskits, Laszlo. Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, 1211, Geneva 14, Switzerland
    • Sanchez-Pena, Paola. Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie-Paris 6, 75013, Paris, France
    • Robin, Xavier. Biomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre, DBSB/CMU, Rue Michel Servet, 1, 1211, Geneva 4, Switzerland
    • Hainard, Alexandre. Biomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre, DBSB/CMU, Rue Michel Servet, 1, 1211, Geneva 4, Switzerland
    • Gex-Fabry, Marianne. Department of Psychiatry, University Hospital of Geneva, 1225, Chêne-Bourg, Switzerland
    • Fouda, Catherine. Biomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre, DBSB/CMU, Rue Michel Servet, 1, 1211, Geneva 4, Switzerland
    • Bassem, Hadiji. Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie-Paris 6, 75013, Paris, France
    • Mueller, Markus. Swiss Institute of Bioinformatics, Medical University Centre, 1211, Geneva 4, Switzerland
    • Lisacek, Frédérique. Swiss Institute of Bioinformatics, Medical University Centre, 1211, Geneva 4, Switzerland
    • Puybasset, Louis. Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie-Paris 6, 75013, Paris, France
    • Sanchez, Jean-Charles. Biomedical Proteomics Research Group, Department of Structural Biology and Bioinformatics, Medical University Centre, DBSB/CMU, Rue Michel Servet, 1, 1211, Geneva 4, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321067
    Summary
    Purpose: Accurate early anticipation of long-term irreversible brain damage during the acute phase of patients with aneurysmal subarachnoid hemorrhage (aSAH) remains difficult. Using a combination of clinical scores together with brain injury-related biomarkers (H-FABP, NDKA, UFD1 and S100β), this study aimed at developing a multiparameter prognostic panel to facilitate early outcome prediction following aSAH. Methods: Blood samples of 141 aSAH patients from two separated cohorts (sets of 28 and 113 patients) were prospectively enrolled and analyzed with 14months of delay. Patients were admitted within 48h following aSAH onset. A venous blood sample was withdrawn within 12h after admission. H-FABP, NDKA, UFD1, S100β and troponin I levels were determined using classical immunoassays. The World Federation of Neurological Surgeons (WFNS) at admission and the Glasgow Outcome Score (GOS) at 6months were evaluated. Results: In the two cohorts, blood concentration of H-FABP, S100β and troponin I at admission significantly predicted unfavorable outcome (GOS 1-2-3). A multivariate analysis identified a six-parameter panel, including WFNS, H-FABP, S100β, troponin I, NDKA and UFD-1; when at least three of these parameters were simultaneously above cutoff values, prediction of unfavorable outcome reached around 70% sensitivity in both cohorts for 100% specificity. Conclusion: The use of this panel, including four brain injury-related proteins, one cardiac marker and a clinical score, could be a valuable tool to identify aSAH patients at risk of poor outcome