Objective:
With the aging of the world population, the number of elderly patients suffering
from aneurysmal subarachnoid hemorrhage (aSAH) is gradually growing. We aim to investigate
the potential association between plasma ALT level and clinical complications of elderly
aSAH patients, and explore its predictive value for clinical outcomes of elderly aSAH patients.
Methods:
Between January 2013 and March 2018, 152 elderly aSAH patients were analyzed in
this study. Clinical information, imaging findings and laboratory data were reviewed. According to
the Glasgow Outcome Scale (GOS), clinical outcomes at 3 months were classified into favorable
outcomes (GOS 4-5) and poor outcomes (GOS 1-3). Logistic regression analysis was used to assess
the indicators associated with poor outcomes, and receiver curves (ROC) and corresponding
area under the curve (AUC) were used to detect the accuracy of the indicator.
Results:
A total of 48 (31.6 %) elderly patients with aSAH had poor outcome at 3 months. In addition
to ICH, IVH, Hunt-Hess 4 or 5 Grade and Modified Fisher 3 or 4 Grade, plasma ALT level
was also strongly associated with poor outcome of elderly aSAH patients. After adjusting for other
covariates, plasma ALT level remained independently associated with pulmonary infection (OR
1.05; 95% CI 1.00–1.09; P = 0.018), cardiac complications (OR 1.05; 95% CI 1.01–1.08; P =
0.014) and urinary infection (OR 1.04; 95% CI 1.00–1.08; P = 0.032). Besides, plasma ALT level
had a predictive ability in the occurrence of systemic complications (AUC 0.676; 95% CI: 0.586–
0.766; P<0.001) and poor outcome (AUC 0.689; 95% CI: 0.605–0.773; P<0.001) in elderly aSAH
patients.
Conclusion:
Plasma ALT level of elderly patients with aSAH was significantly associated with
systemic complications, and had additional clinical value in predicting outcomes. Given that
plasma ALT levels on admission could help to identify high-risk elderly patients with aSAH, these
findings are of clinical relevance.
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