Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?

• Published in: Journal of stroke and cerebrovascular diseases 2017-05, Vol.26 (5), p.1007-1012
• Main Authors: Elhechmi, Youssef Zied, MD, Hassouna, Malek, MR (Medical Resident), Chérif, Mohamed A., MD, Ben Kaddour, Rym, MD, Sedghiani, Ines, MD, Jerbi, Zouheir, MD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Cardiovascular; Cerebral Hemorrhage - blood; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - mortality; Female; Hospital Mortality; Humans; inflammation; Intracerebral hemorrhage; Logistic Models; Male; Middle Aged; mortality; Multivariate Analysis; Neurology; Odds Ratio; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Factors; Time Factors
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2016.11.129

Background Several studies showed a correlation between C-reactive protein and mortality in spontaneous intracerebral hemorrhage. However, the best time to measure C-reactive protein to assess prognosis is not yet clear. The purpose of this study was to determine if initial or H24-C-reactive protein is independently associated with 30-day mortality in intracerebral hemorrhage. Methods This is a retrospective study done within years 2010-2015. All intracerebral hemorrhage cases with missing data or with autoimmune disease or neoplasm were excluded. Univariate and multivariate analyses were assessed for initial C-reactive protein, H24-C-reactive protein, and confounding factors. Results Of 122 patients, 91 were selected. Only H24-C-reactive protein, hematoma volume, and infratentorial origin were independently associated with 30-day mortality in intracerebral hemorrhage. When adjusted with intracerebral hemorrhage score, H24-C-reactive protein with a cutoff value of 30 mg/L independently predicted 30-day mortality. Conclusions This study suggests that H24-C-reactive protein may be a more reliable marker than initial C-reactive protein in the prediction of mortality in intracerebral hemorrhage. A large multicentric study is necessary to confirm the interest of including H24-C-reactive protein to a modified intracerebral hemorrhage score for the prediction of 30-day mortality.