Can Serum Procalcitonin Levels Distinguish Between Systemic Inflammatory Response Syndrome And Systemic Infection In Aneurysmal Subarachnoid Hemorrhage Patients?

Author(s):  
Matthew Stritt ◽  
William D. Freeman ◽  
Ognjen Gajic ◽  
Emir Festic
2019 ◽  
Vol 130 (6) ◽  
pp. 1984-1991 ◽  
Author(s):  
Aaron P. Wessell ◽  
Matthew J. Kole ◽  
Gregory Cannarsa ◽  
Jeffrey Oliver ◽  
Gaurav Jindal ◽  
...  

OBJECTIVEThe authors sought to evaluate whether a sustained systemic inflammatory response was associated with shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage.METHODSA retrospective analysis of 193 consecutive patients with aneurysmal subarachnoid hemorrhage was performed. Management of hydrocephalus followed a stepwise algorithm to determine the need for external CSF drainage and subsequent shunt placement. Systemic inflammatory response syndrome (SIRS) data were collected for all patients during the first 7 days of hospitalization. Patients who met the SIRS criteria every day for the first 7 days of hospitalization were considered as having a sustained SIRS. Univariate and multivariate regression analyses were used to determine predictors of shunt dependence.RESULTSSixteen percent of patients required shunt placement. Sustained SIRS was observed in 35% of shunt-dependent patients compared to 14% in non–shunt-dependent patients (p = 0.004). On multivariate logistic regression, female sex (OR 0.35, 95% CI 0.142–0.885), moderate to severe vasospasm (OR 3.78, 95% CI 1.333–10.745), acute hydrocephalus (OR 21.39, 95% CI 2.260–202.417), and sustained SIRS (OR 2.94, 95% CI 1.125–7.689) were significantly associated with shunt dependence after aneurysmal subarachnoid hemorrhage. Receiver operating characteristic analysis revealed an area under the curve of 0.83 for the final regression model.CONCLUSIONSSustained SIRS was a predictor of shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage even after adjustment for potential confounding variables in a multivariate logistic regression model.


2018 ◽  
Vol 46 (12) ◽  
pp. e1152-e1159 ◽  
Author(s):  
Verena Rass ◽  
Max Gaasch ◽  
Mario Kofler ◽  
Alois Josef Schiefecker ◽  
Bogdan-Andrei Ianosi ◽  
...  

2021 ◽  
Author(s):  
Fushu Luo ◽  
Yuanyou Li ◽  
Yutong Zhao ◽  
Mingjiang Sun ◽  
Qiuguang He ◽  
...  

Abstract Objectives: Systemic inflammatory response is closely related to the pathogenesis and prognosis in critical patients. Recently, systemic immune-inflammation index (SII), an indicator of systemic inflammatory response, was proved to predict the outcome in cancerous and non-cancerous diseases. The aim of this study is to evaluate the relationship between SII on admission and 6-month outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods: The clinical data and prognosis of 76 patients with aSAH was analyzed. Patients were divided into high SII group and low SII group. The 6-month outcome was assessed by the modified Rankin scale (mRS).The unfavorable outcome was defined as mRS score ≥3. Receiver operating characteristics (ROC), area under the curve (AUC) and logistic regression were used to examine the relations between SII levels and 6-month clinical outcomes.Results: Thirty-six patients (47.4%) in our study had a unfavorable outcome (mRS ≥3) at 6 months, and twenty-four (66.7%) of them had high SII. Spearman correlation analysis showed that the SII was correlated with mRS (r=0.418, P<0.05). Binary logistic regression showed that there was an independent association between SII on admission and 6-month clinical outcome (OR=4.271, 95%CI: 1.047-17.422, P<0.05). The AUC of the SII for predicting unfavorable outcome was 0.692(95% CI:0.571–0.814, P<0.05).Conclusion: Systemic immune-inflammation index (SII) could be a novel independent prognostic factor for aSAH patients at the early stage of the disease.


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