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

Serum LDH levels may predict poor neurological outcome after aneurysmal subarachnoid hemorrhage

Authors: Irene Cavalli, Claudia Stella, Timothée Stoll, Luciana Mascia, Michele Salvagno, Giacomo Coppalini, Alberto Diosdado, Marco Menozzi, Daniela Diaferia, Narcisse Ndieugnou Djangang, Fernando Oliveira, Sophie Schuind, Fabio Silvio Taccone, Elisa Gouvêa Bogossian

Published in: BMC Neurology | Issue 1/2023

Abstract

Introduction

Serum lactate dehydrogenase (LDH) levels are often elevated in cardiovascular diseases. Their prognostic role after subarachnoid hemorrhage (SAH) remains poorly evaluated.

Methods

This is a retrospective single-center study of patients with non-traumatic SAH admitted to the intensive care unit (ICU) of an University Hospital from 2007 to 2022. Exclusion criteria were pregnancy and incomplete medical records or follow-up data. Baseline information, clinical data, radiologic data, the occurrence of neurological complications as well as serum LDH levels during the first 14 days of ICU stay were collected. Unfavorable neurological outcome (UO) at 3 months was defined as a Glasgow Outcome Scale of 1–3.

Results

Five hundred and forty-seven patients were included; median serum LDH values on admission and the highest LDH values during the ICU stay were 192 [160–230] IU/L and 263 [202–351] IU/L, respectively. The highest LDH value was recorded after a median of 4 [2–10] days after ICU admission. LDH levels on admission were significantly higher in patients with UO. When compared with patients with favorable outcome (FO), patients with UO had higher serum LDH values over time. In the multivariate logistic regression model, the highest LDH value over the ICU stay (OR 1.004 [95% CI 1.002 – 1.006]) was independently associated with the occurrence of UO; the area under the receiving operator (AUROC) curve for the highest LDH value over the ICU stay showed a moderate accuracy to predict UO (AUC 0.76 [95% CI 0.72–0.80]; p < 0.001), with an optimal threshold of > 272 IU/L (69% sensitivity and 74% specificity).

Conclusions

The results in this study suggest that high serum LDH levels are associated with the occurrence of UO in SAH patients. As a readily and available biomarker, serum LDH levels should be evaluated to help with the prognostication of SAH patients.

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Title: Serum LDH levels may predict poor neurological outcome after aneurysmal subarachnoid hemorrhage
Authors: Irene Cavalli
Claudia Stella
Timothée Stoll
Luciana Mascia
Michele Salvagno
Giacomo Coppalini
Alberto Diosdado
Marco Menozzi
Daniela Diaferia
Narcisse Ndieugnou Djangang
Fernando Oliveira
Sophie Schuind
Fabio Silvio Taccone
Elisa Gouvêa Bogossian
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Intracranial Hypertension
Biomarkers
Published in: BMC Neurology / Issue 1/2023
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-023-03282-8

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Serum LDH levels may predict poor neurological outcome after aneurysmal subarachnoid hemorrhage

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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