S100B, NSE and MMP-9 fail to predict neurologic outcome while elevated S100B associates with milder initial clinical presentation after aneurysmal subarachnoid hemorrhage

Kiiski, Heikki; Långsjö, Jaakko; Tenhunen, Jyrki; Ala-Peijari, Marika; Huhtala, Heini; Hämäläinen, Mari; Moilanen, Eeva; Peltola, Jukka

doi:10.1016/j.jns.2018.04.030

Cited by 11 publications

(9 citation statements)

References 39 publications

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“…Importantly, early S100B measurements predicted patient mortality 3-4 days before high intracranial pressure (ICP) readings predicted the same. Quite the opposite results were documented recently by Kiiski et al, who found that elevated S100B at day 1 was strongly associated with a less severe initial clinical representation of aSAH, and the study concluded that plasmatic biomarkers should not be used to guide clinical decision-making in patients with aSAH, in prognostication based on S100B [3].…”

Section: Discussioncontrasting

confidence: 54%

“…On admission, patients were assessed using the Glasgow Coma Scale (GCS). Subarachnoid haemorrhage severity was evaluated with the Hunt and Hess (H-H) scale and defined as severe (4-5) or moderate (1)(2)(3). The extent of haemorrhaging was assessed with a computerized tomography (CT) scan of the head and classified using the Fisher scale, where 1 = no subarachnoid (SAH) or intraventricular haemorrhage (IVH) detected, 2 = diffuse thin (<1 mm) SAH, no clots, 3 = localized clots and/or layers of blood >1 mm in thickness, no IVH, and 4 = diffuse or no SAH an intracerebral or intraventricular clot.…”

Section: Clinical Assessmentmentioning

confidence: 99%

“…In patients who have suffered brain injury, the concentrations of certain markers in the cerebrospinal fluid (CSF) and blood are correlated with the severity of brain damage and the outcome [1][2][3]. Markers specific to the central nervous system (CNS) have been the focus of research as potential post-injury outcome biomarkers, in particular those derived from neurons and astrocytes [4].…”

Section: Introductionmentioning

confidence: 99%

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Brain-Specific Biomarkers as Mortality Predictors after Aneurysmal Subarachnoid Haemorrhage

Kędziora

Burzyńska

Goździk

et al. 2020

JCM

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Aneurysmal subarachnoid haemorrhage (aSAH) is a serious condition with a high mortality and high permanent disability rate for those who survive the initial haemorrhage. The purpose of this study was to investigate markers specific to the central nervous system as potential in-hospital mortality predictors after aSAH. In patients with an external ventricular drain, enolase, S100B, and GFAP levels were measured in the blood and cerebrospinal fluid (CSF) on days 1, 2, and 3 after aSAH. Compared to survivors, non-survivors showed a significantly higher peak of S100B and enolase levels in the blood (S100B: 5.7 vs. 1.5 ng/mL, p = 0.031; enolase: 6.1 vs. 1.4 ng/mL, p = 0.011) and the CSF (S100B: 18.3 vs. 0.9 ng/mL, p = 0.042; enolase: 109.2 vs. 6.1 ng/mL, p = 0.015). Enolase showed the highest level of predictability at 1.8 ng/mL in the blood (AUC of 0.873) and 80.0 ng/mL in the CSF (AUC of 0.889). The predictive ability of S100B was also very good with a threshold of 5.7 ng/mL in the blood (AUC 0.825) and 4.5 ng/mL in the CSF (AUC 0.810). In conclusion, enolase and S100B, but not GFAP, might be suitable as biomarkers for the early prediction of in-hospital mortality after aSAH.

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Section: Discussioncontrasting

confidence: 54%

Section: Clinical Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brain-Specific Biomarkers as Mortality Predictors after Aneurysmal Subarachnoid Haemorrhage

Kędziora

Burzyńska

Goździk

et al. 2020

JCM

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“…Quite opposite results have recently been published. Kiiski et al [ 30 ] found that S100B and NSE measured during the first 24 h were not associated with neurological outcome evaluated at 6 months after an aSAH. Similar results were published by Olivecrona et al [ 31 ]; based on the biomarker concentrations determined twice daily for five consecutive days, there was no significant clinical value of S100B and NSE as predictors of clinical outcome at 3 and 12-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers of Neurological Outcome After Aneurysmal Subarachnoid Hemorrhage as Early Predictors at Discharge from an Intensive Care Unit

et al. 2020

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Background Subarachnoid bleeding is associated with brain injuries and ranges from almost negligible to acute and life threatening. The main objectives were to study changes in brain-specific biomarker levels in patients after an aneurysmal subarachnoid hemorrhage (aSAH) in relation to early clinical findings, severity scores, and intensive care unit (ICU) outcome. Analysis was done to identify specific biomarkers as predictors of a bad outcome in the acute treatment phase. Methods Analysis was performed for the proteins of neurofilament, neuron-specific enolase (NSE), microtubule-associated protein tau (MAPT), and for the proteins of glial cells, S100B, and glial fibrillary acidic protein (GFAP). Outcomes were assessed at discharge from the ICU and analyzed based on the grade in the Glasgow Outcome Scale (GOS). Patients were classified into two groups: with a good outcome (Group 1: GOS IV–V, n = 24) and with a bad outcome (Group 2: GOS I–III, n = 31). Blood samples were taken upon admission to the ICU and afterward daily for up to 6 days. Results In Group 1, the level of S100B (1.0, 0.9, 0.7, 2.0, 1.0, 0.3 ng/mL) and NSE (1.5, 2.0, 1.6, 1.2, 16.6, 2.2 ng/mL) was significantly lower than in Group 2 (S100B: 4.7, 4.8, 4.4, 4.5, 6.6, 6.8 ng/mL; NSE: 4.0, 4.1, 4.3, 3.8, 4.4, 2.5 1.1 ng/mL) on day 1–6, respectively. MAPT was significantly lower only on the first and second day (83.2 ± 25.1, 132.7 ± 88.1 pg/mL in Group 1 vs. 625.0 ± 250.7, 616.4 ± 391.6 pg/mL in Group 2). GFAP was elevated in both groups from day 1 to 6. In the ROC analysis, S100B showed the highest ability to predict bad ICU outcome of the four biomarkers measured on admission [area under the curve (AUC) 0.81; 95% CI 0.67–0.94, p < 0.001]. NSE and MAPT also had significant predictive value (AUC 0.71; 95% CI 0.54–0.87, p = 0.01; AUC 0.74; 95% CI 0.55–0.92, p = 0.01, respectively). A strong negative correlation between the GOS and S100B and the GOS and NSE was recorded on days 1–5, and between the GOS and MAPT on day 1. Conclusion Our findings provide evidence that brain biomarkers such as S100B, NSE, GFAP, and MAPT increase significantly in patients following aSAH. There is a direct relationship between the neurological outcome in the acute treatment phase and the levels of S100B, NSE, and MAPT. The detection of brain-specific biomarkers in conjunction with clinical data may constitute a valuable diagnostic and prognostic tool in the early phase of aSAH treatment.

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“…Intracranial aneurysmal subarachnoid haemorrhage (aSAH) is an acute cerebral vascular disease that severely damages the central nervous system and has pathological effects on multiple organs in the body. Wang (2015) and Xu, Wang, Hu, and Liang (2015) stated that the aSAH patient has rapid onset, critical symptoms, volatile conditions, difficult nursing and 50% mortality rate after onset within 1 year (Kiiski et al, 2018), which suggests higher demand for nursing.…”

Section: Introductionmentioning

confidence: 99%

Application of inter‐professional care model in patients with aneurysmal subarachnoid haemorrhage

Juan¹,

Yan³

2020

J Nurs Manag

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Objective: To explore the feasibility and effect of the inter-professional care model in patients with aneurysmal subarachnoid haemorrhage.Methods: A convenient sampling method was used to recruit inpatients of a hospital as subjects from July 2016 to July 2018. According to the even/odd attribute of admission number, subjects were divided into a control group and an observation group. The number of recruited subjects was 311: the control group comprised 135 participants and the observation group 176. The average length of hospital stay, hospital fees, quality of life, and satisfaction with the quality of nursing were compared between the two groups. SPIRIT checklist was completed (see File S1). Results:After intervention, patients in the observation group had shorter average hospital stay (15.98 ± 2.7), lower hospital fees (81,018 ± 1.3), higher satisfaction with the quality of nursing (98.3%), lower incidence of complications (19.89%), improved ability to perform activities of daily living, and lower rate of disease outcome and readmission, with statistically significant differences from the control group (p < .05). Conclusion:The application of inter-professional care model in single disease patients with aneurysmal subarachnoid haemorrhage can shorten the average hospital stay, reduce hospital fees, improve the quality of life of patients, and increase patients' satisfaction with the quality of nursing, which is worthy of clinical promotion and application. Implications for nursing management section:Nursing managers can use this model to improve the ability to ensure coordination between medical professionals and integrate the ability of nursing problems, the ability to make rational distribution of nursing human resources, and the ability of critical thinking. It can be used as reference to improve the nursing management of all kinds of single diseases. K E Y W O R D Saneurysmal subarachnoid haemorrhage, conventional holistic care, inter-professional care model, nursing

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S100B, NSE and MMP-9 fail to predict neurologic outcome while elevated S100B associates with milder initial clinical presentation after aneurysmal subarachnoid hemorrhage

Cited by 11 publications

References 39 publications

Brain-Specific Biomarkers as Mortality Predictors after Aneurysmal Subarachnoid Haemorrhage

Brain-Specific Biomarkers as Mortality Predictors after Aneurysmal Subarachnoid Haemorrhage

Biomarkers of Neurological Outcome After Aneurysmal Subarachnoid Hemorrhage as Early Predictors at Discharge from an Intensive Care Unit

Application of inter‐professional care model in patients with aneurysmal subarachnoid haemorrhage

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