Berek Anna, Berek Klaus, Kindl Philipp, Di Pauli Franziska, Schiefecker Alois J, Pfausler Bettina, Helbok Raimund, Deisenhammer Florian, Beer Ronny, Hegen Harald, Rass Verena
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Neurology, Johannes Kepler University Linz, Linz, Austria.
Eur J Neurol. 2025 Apr;32(4):e70164. doi: 10.1111/ene.70164.
Prognostication after subarachnoid hemorrhage (SAH) is essential to guide clinical management and improve patient care.
To investigate whether decay rates of cerebrospinal fluid (CSF) red blood cells (RBC) and total protein (TP) after SAH predict functional outcome at 3 months.
Patients with SAH treated at the Neurological Intensive Care Unit Innsbruck with a first CSF sample (CSFfirst) within 72 h after admission and at least one subsequent sample were eligible for inclusion. Decay rates of RBC and TP were measured between CSFfirst and each subsequent measurement (Weeks 1-3). Modified Rankin Scale scores at 3 months ≤ 2 were defined as good functional outcomes.
A total of 97 patients with a median age of 61 years [25th; 75th percentile: 52;71] and a median Hunt and Hess score of 4 [3;5] were included. Daily RBC decay rates decreased over time, while daily TP decay rates were highest in Week 1, showed a nadir in Week 2, and increased again in Week 3. In multivariable analysis, higher RBC (adjusted odds ratio (adjOR): 1.13, 95% confidence interval (95% CI): 1.02-1.26, p = 0.025) and TP (adjOR: 1.01, 95% CI: 1.00-1.01, p = 0.031) decay rates at Week 3 predicted a good functional outcome at Month 3. RBC and TP decreasing below 1180 cells/μL and 127.5 mg/dL, respectively, at Week 3 were associated with good functional outcome at Month 3 (adjOR: 11.04, 95% CI: 3.21-38.02, p < 0.001 and 6.03, 1.68-21.67, p = 0.006).
Decay rates of CSF RBC and TP after SAH are associated with functional outcomes.
蛛网膜下腔出血（SAH）后的预后评估对于指导临床管理和改善患者护理至关重要。
研究SAH后脑脊液（CSF）红细胞（RBC）和总蛋白（TP）的衰减率是否能预测3个月时的功能结局。
因SAH在因斯布鲁克神经重症监护病房接受治疗的患者，若在入院后72小时内采集了首次脑脊液样本（CSFfirst）且至少有一份后续样本，则符合纳入标准。在CSFfirst和每次后续测量（第1 - 3周）之间测量RBC和TP的衰减率。3个月时改良Rankin量表评分≤2被定义为良好的功能结局。
共纳入97例患者，中位年龄61岁[第25百分位数；第75百分位数：52；71]，Hunt和Hess中位评分为4[3；5]。每日RBC衰减率随时间下降，而每日TP衰减率在第1周最高，在第2周达到最低点，在第3周再次升高。在多变量分析中，第3周时较高的RBC（调整优势比（adjOR）：1.13，95%置信区间（95%CI）：1.02 - 1.26，p = 0.025）和TP（adjOR：1.01，95%CI：1.00 - 1.01，p = 0.031）衰减率预测3个月时功能结局良好。第3周时RBC和TP分别降至低于1180个细胞/μL和127.5mg/dL与3个月时良好的功能结局相关（adjOR：11.04，95%CI：3.21 - 38.02，p < 0.001和6.03，1.68 - 21.67，p = 0.006）。
SAH后CSF RBC和TP的衰减率与功能结局相关。
Zotero 插件
