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BMC Neurology
Published in: BMC Neurology 1/2023

Open Access 01-12-2023 | Subarachnoid Hemorrhage | Research

Clinical value of the low-grade inflammation score in aneurysmal subarachnoid hemorrhage

Authors: Ling wang, Ling Chen, Yang Jin, Xiangyang Cao, Liujun Xue, Qiantao Cheng

Published in: BMC Neurology | Issue 1/2023

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Abstract

Background and purpose

Multiple inflammatory biomarkers have been shown to predict symptomatic cerebral vasospasm (SCVS) and poor functional outcome in patients with aneurysmal subarachnoid hemorrhage. However, the impact of the low-grade inflammation (LGI) score, which can reflect the synergistic effects of five individual inflammatory biomarkers on SCVS and poor functional outcome on aneurysmal subarachnoid hemorrhage (aSAH), has not yet been well established. The aim of this study was to evaluate the impact of the LGI score on SCVS and poor functional outcome in aSAH patients.

Methods

The LGI score was calculated as the sum of 10 quantiles of each individual inflammatory biomarker. The association of the LGI score with the risk of SCVS and poor functional outcome was analyzed with multivariate logistical regression.

Results

A total of 270 eligible aSAH patients were included in this study: 74 (27.4%) had SCVS, and 79 (29.3%) had poor functional outcomes. After adjusting for confounders, a higher LGI score was revealed to independently predict SCVS (OR, 1.083; 95% CI, 1.011–1.161; P = 0.024) and poor functional outcome (OR, 1.132; 95% CI, 1.023–1.252; P = 0.016), and the second and third tertile group had higher risk of SCVS than lowest tertile group (OR, 2.826; 95% CI, 1.090–7.327; P = 0.033) (OR, 3.243; 95% CI, 1.258–8.358; P = 0.015). The receiver operating characteristic (ROC) curve uncovered the ability of the LGI score to distinguish patients with and without SCVS (area under the curve [AUC] = 0.746; 95% CI, 0.690–0.797; P < 0.001) and poor functional outcomes (area under the curve [AUC] = 0.799; 95% CI, 0.746–0.845; P < 0.001), the predictive value of LGI on SCVS and poor functional outcome is superior than PLT, NLR and WBC, but there was no statistical difference between LGI and CRP for predicting SCVS (P = 0.567) and poor functional outcome (P = 0.171).

Conclusions

A higher LGI which represents severe low grade inflammation status is associated with SCVS and poor functional outcome at 3 months after aSAH.
Literature
1.
2.
3.
Rass V, et al. Systemic inflammatory response syndrome as predictor of poor outcome in nontraumatic subarachnoid Hemorrhage patients. Crit Care Med. 2018;46(12):e1152–9.CrossRefPubMed
4.
Yoshimoto Y, et al. Acute systemic inflammatory response syndrome in subarachnoid Hemorrhage. Stroke. 2001;32(9):1989–93.CrossRefPubMed
5.
Guo Y, et al. Neutrophil to lymphocyte ratio predicting poor outcome after aneurysmal subarachnoid Hemorrhage: a retrospective study and updated meta-analysis. Front Immunol. 2022;13:962760.CrossRefPubMedPubMedCentral
6.
Wang L, et al. Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid Hemorrhage complicated with hydrocephalus. Front Neurol. 2022;13:1014501.CrossRefPubMedPubMedCentral
7.
Engström G, et al. Incidence of obesity-associated Cardiovascular Disease is related to inflammation-sensitive plasma proteins: a population-based cohort study. Arterioscler Thromb Vasc Biol. 2004;24(8):1498–502.CrossRefPubMed
8.
9.
10.
Gaetano Gd, et al. Polyphenol intake is associated with low-grade inflammation, using a novel data analysis from the Moli-Sani study. Thromb Haemost. 2017;115(02):344–52.
11.
Kalsch AI, et al. Long- and short-term association of low-grade systemic inflammation with cardiovascular mortality in the LURIC study. Clin Res Cardiol. 2020;109(3):358–73.CrossRefPubMed
12.
Bonaccio M, et al. A score of low-grade inflammation and risk of mortality: prospective findings from the Moli-Sani study. Haematologica. 2016;101(11):1434–41.CrossRefPubMedPubMedCentral
13.
14.
Aggarwal A, et al. Comparative evaluation of H&H and WFNS grading scales with modified H&H (sans systemic Disease): a study on 1000 patients with subarachnoid Hemorrhage. Neurosurg Rev. 2018;41(1):241–7.CrossRefPubMed
15.
Frontera JA, et al. Prediction of symptomatic Vasospasmafter Subarachnoid Hemorrhage: the Modified Fisher Scale. Neurosurgery. 2006;59(1):21–7.PubMed
16.
Frontera JA, et al. Defining vasospasm after subarachnoid Hemorrhage: what is the most clinically relevant definition? Stroke. 2009;40(6):1963–8.CrossRefPubMed
17.
Dilraj A, et al. Levels of catecholamine in plasma and cerebrospinal fluid in aneurysmal subarachnoid Hemorrhage. Neurosurgery. 1992;31(1):42–50.PubMed
18.
Naredi S, et al. Sympathetic activation and inflammatory response in patients with Subarachnoid Haemorrhage. Intensive Care Med. 2006;32(12):1955–61.CrossRefPubMed
19.
Lobato RD, et al. Cerebrovascular reactivity to noradrenaline and serotonin following experimental subarachnoid Hemorrhage. J Neurosurg. 1980;53(4):480–5.CrossRefPubMed
20.
Borovac JA, et al. Sympathetic nervous system activation and Heart Failure: current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol. 2020;12(8):373–408.CrossRefPubMedPubMedCentral
21.
Seematter G, et al. Relationship between stress, inflammation and metabolism. Curr Opin Clin Nutr Metab Care. 2004;7(2):169–73.CrossRefPubMed
22.
Provencio JJ, et al. Subarachnoid Hemorrhage and inflammation: bench to bedside and back. Semin Neurol. 2005;25(4):435–44.CrossRefPubMed
23.
Sarrafzadeh A, et al. Immunodepression after aneurysmal subarachnoid Hemorrhage. Stroke. 2011;42(1):53–8.CrossRefPubMed
24.
Friedrich V, et al. Reduction of neutrophil activity decreases early microvascular injury after Subarachnoid Haemorrhage. J Neuroinflammation. 2011;8:103.CrossRefPubMedPubMedCentral
25.
Hanhai Z, et al. Neutrophil extracellular traps, released from neutrophil, promote microglia inflammation and contribute to poor outcome in subarachnoid Hemorrhage. Aging. 2021;13(9):13108–23.CrossRefPubMedPubMedCentral
26.
Dumont AS et al. Cerebral vasospasm after subarachnoid Hemorrhage: putative role of inflammation. Neurosurgery. 2003;53(1):123–33; discussion 133-5.
27.
Buce-Satoba I, et al. Leukocytosis and C-reactive protein may predict development of secondary cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. Med (Kaunas). 2022;58(2).
28.
Spallone A, et al. Relationship between leukocytosis and ischemic Complications following aneurysmal subarachnoid Hemorrhage. Surg Neurol. 1987;27(3):253–8.CrossRefPubMed
29.
Al-Mufti F, et al. White Blood Cell Count improves prediction of delayed cerebral ischemia following aneurysmal subarachnoid Hemorrhage. Neurosurgery. 2019;84(2):397–403.CrossRefPubMed
30.
Pepys MB, et al. Acute phase proteins with special reference to C-reactive protein and related proteins (pentaxins) and serum amyloid A protein. Adv Immunol. 1983;34:141–212.CrossRefPubMed
31.
Gaastra B, et al. CRP (C-Reactive protein) in Outcome Prediction after Subarachnoid Hemorrhage and the role of machine learning. Stroke. 2021;52(10):3276–85.CrossRefPubMed
32.
Metadata
Title
Clinical value of the low-grade inflammation score in aneurysmal subarachnoid hemorrhage
Authors
Ling wang
Ling Chen
Yang Jin
Xiangyang Cao
Liujun Xue
Qiantao Cheng
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2023
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-023-03490-2

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