In-hospital C-reactive protein predicts outcome after aneurysmal subarachnoid haemorrhage treated by endovascular coiling

• Published in: Acta anaesthesiologica Scandinavica 2015-02, Vol.59 (2), p.255-264
• Main Authors: CSAJBOK, L. Z., NYLÉN, K., ÖST, M., SONANDER, H., NELLGÅRD, B.
• Format: Article
• Language: English
• Subjects: Anestesi och intensivvård; Anesthesiology and Intensive Care; Aneurysm, Ruptured - blood; Aneurysm, Ruptured - complications; Aneurysms; Biomarkers - blood; C-Reactive Protein; Endovascular Procedures - methods; Female; Humans; Inpatients - statistics & numerical data; Intracranial Aneurysm - blood; Intracranial Aneurysm - complications; Male; Medical research; Middle Aged; Predictive Value of Tests; Prospective Studies; Subarachnoid Hemorrhage - blood; Subarachnoid Hemorrhage - etiology; Subarachnoid Hemorrhage - therapy; Treatment Outcome
• ISSN: 0001-5172; 1399-6576; 1399-6576
• DOI: 10.1111/aas.12441

Background This study aimed to examine prospectively whether the inflammatory marker C‐reactive protein (CRP) increases in patients with aneurysmal subarachnoid haemorrhage (aSAH) treated by endovascular coiling and investigate whether CRP could be used as prognostic factor for long‐term neurological outcome. Methods This single‐hospital study comprised 98 consecutive patients with confirmed aSAH treated by endovascular coiling. Admission status was classified according to the World Federation of Neurosurgical Societies (WFNS) Scale and initial cerebral computed tomography according to Fisher scale. CRP was analysed on days 0, 1, 2, 3, 4, 6 and 8 after the initial bleed. A neurological follow up was performed 1 year later according to the Extended Glasgow Outcome Scale (GOSE) for overall outcome and National Institute of Health Stroke Scale (NIHSS) for focal deficit. Results CRP values increased from normal to peak at 53 mg/l at day 3–4 and then declined, without normalising, at day 8. Patients with a higher increase in CRP had a poorer neurological outcome after 1 year. CRP during the first week had a stronger correlation to outcome (r = 0.417) and NIHSS (r = 0.449) than initial clinical status (WFNS; r = 0.280 and 0.274) and radiology (Fisher scale; r = 0.137 and 0.158). CRP increase indicated a risk of poor outcome (GOSE) (P