RVD2 emerges as a serological marker in relation to severity and six-month clinical outcome following acute intracerebral hemorrhage: A prospective cohort study from a single academic institution.

BACKGROUND

Resolvin D2 (RvD2), with an anti-inflammatory activity, harbors a neuroprotective property. Here, serum RvD2 levels were detected with an attempt to explore its prognostic implication in human acute intracerebral hemorrhage (ICH).

METHODS

In this prospective cohort study, serum RvD2 levels of 301 ICH patients, coupled with 100 heathy individuals, were gauged. All patients were randomly divided to two groups (200 patients in the study group and 101 in the validation group) in a 2:1 ratio. Change of serum RvD2 levels after ICH was investigated, and its correlations with National Institutes of Health Stroke Scale (NIHSS) scores, hematoma volume and poststroke six-month modified Rankin Scale (mRS) scores were determined using multivariate analysis. Its independent association with poor prognosis (mRS scores of 3-6) was uncovered in the study group and its prognostic predictive value was verified in the validation group.

RESULTS

The serum levels of RvD2 in patients displayed a notable decline upon admission, as compared to controls. The levels exhibited independent correlations with NIHSS scores, hematoma size and mRS scores. Alternatively, RvD2 levels had independent relation to a poor prognosis after ICH. Within the framework of restricted cubic spline analysis, RvD2 levels were linearly correlated with the likelihood of poor prognosis, even adjusting for NIHSS scores and hematoma size. In the context of receiver operating characteristic (ROC) curve analysis, serum RvD2 dramatically distinguished risk of poor prognosis, with similar predictive ability to NIHSS scores and hematoma volume. By employing subgroup analysis, the relationship between RvD2 levels and poor prognosis was not obviously influenced by other parameters, such as age, sex, hypertension, and more. The integrated model containing serum RvD2, NIHSS scores and hematoma volume was visualized on a nomogram and showed high predictive performance and clinical effectiveness for poor prognosis via multiple evaluation metrics, including the Hosmer-Lemeshow test, ROC curve analysis, calibration curve analysis and decision curve analysis. Clinical usefulness of serum RvD2 was verified in the validation group.

CONCLUSION

Serum RvD2 levels exhibit an immediate decrease post-ICH, which could be able to accurately reflect ICH severity and efficiently prognosticate poor neurological outcomes, signifying that serum RvD2 may represent an encouraging prognostic indicator in ICH.