Wang Ruoran, Zhang Jing, Xu Jianguo, He Min
Department of Neurosurgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan Province, 610041, China.
Department of Critical Care Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan Province, 610041, China.
BMC Neurol. 2025 Apr 10;25(1):151. doi: 10.1186/s12883-025-04162-z.
Aneurysmal subarachnoid hemorrhage (aSAH) patients usually suffer poor survival outcome and severe morbidity. Evaluating prognosis of aSAH patients in acute phase is essential for physicians to make suitable treatments strategies. This study was performed to explore the relation between initial serum cystatin C level and outcome of aSAH patients.
Three hundred seven aSAH patients were included. Univariate and multivariate logistic regression were used to analyze the relationship between initial serum cystatin C level with mortality and unfavorable functional outcome of aSAH patients. Receiver operating characteristic curve (ROC) was drawn and area under the ROC curve (AUC) was calculated to evaluate the prognostic value of serum cystatin C in aSAH.
The incidence of mortality and unfavorable functional outcome in included 307 aSAH patients was 18.2% and 49.2%. Compared with survivors or patients with mRS < 3, non-survivors or those with mRS ≥ 3 had lower GCS and higher WFNS, Hunt-Hess, mFisher score. Serum cystatin C level was also higher in non-survivors or whose mRS ≥ than survivors or whose mRS < 3. Multivariate logistic regression showed serum cystatin C was significantly associated with mortality (p = 0.012) but not unfavorable functional outcome (p = 0.053) of aSAH. The AUC of serum cystatin C for predicting mortality and unfavorable functional outcome of aSAH patients was 0.718 and 0.669, respectively.
Initial serum cystatin C level is positively associated with mortality of aSAH patients. Evaluating serum cystatin C level is useful for clinicians to risk the severity of aSAH patients and therefore make personalized treatments regimen.
动脉瘤性蛛网膜下腔出血（aSAH）患者通常预后较差，病残率高。评估aSAH患者急性期的预后对于医生制定合适的治疗策略至关重要。本研究旨在探讨初始血清胱抑素C水平与aSAH患者预后的关系。
纳入307例aSAH患者。采用单因素和多因素逻辑回归分析初始血清胱抑素C水平与aSAH患者死亡率及不良功能结局之间的关系。绘制受试者工作特征曲线（ROC）并计算曲线下面积（AUC），以评估血清胱抑素C在aSAH中的预后价值。
307例aSAH患者中，死亡率和不良功能结局的发生率分别为18.2%和49.2%。与幸存者或改良Rankin量表（mRS）评分<3分的患者相比，非幸存者或mRS评分≥3分的患者格拉斯哥昏迷量表（GCS）评分更低，世界神经外科联盟（WFNS）、Hunt-Hess、mFisher评分更高。非幸存者或mRS评分≥3分患者的血清胱抑素C水平也高于幸存者或mRS评分<3分的患者。多因素逻辑回归显示，血清胱抑素C与aSAH患者的死亡率显著相关（p = 0.012），但与不良功能结局无关（p = 0.053）。血清胱抑素C预测aSAH患者死亡率和不良功能结局的AUC分别为0.718和0.669。
初始血清胱抑素C水平与aSAH患者的死亡率呈正相关。评估血清胱抑素C水平有助于临床医生判断aSAH患者的病情严重程度，从而制定个性化的治疗方案。
