Biomarkers of Functional Outcome in Intracerebral Hemorrhage: Interplay between Clinical Metrics, CD163, and Ferritin

Background Intracerebral hemorrhage (ICH) is associated with neurological decline and poor prognosis. Although many etiologic models have been explored, secondary damage caused by continued inflammation and iron exposure from red blood cell lysis may explain poor outcomes at distant follow-up. Exami...

Full description

Saved in:
Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2017-08, Vol.26 (8), p.1712-1720
Main Authors: Garton, Andrew L.A., BS, Gupta, Vivek P., BA, Christophe, Brandon R., BA, Connolly, E. Sander, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Antigens, CD - blood
Antigens, Differentiation, Myelomonocytic - blood
APACHE
Biomarkers
Biomarkers - blood
Cardiovascular
Cerebral Hemorrhage - blood
Cerebral Hemorrhage - diagnosis
Cerebral Hemorrhage - physiopathology
Disability Evaluation
Female
Ferritins - blood
functional outcome
Hepcidins - blood
Humans
intracerebral hemorrhage
iron regulation
Logistic Models
Male
Middle Aged
Multivariate Analysis
Neurology
Odds Ratio
Predictive Value of Tests
Receptors, Cell Surface - blood
Recovery of Function
Retrospective Studies
Time Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Intracerebral hemorrhage (ICH) is associated with neurological decline and poor prognosis. Although many etiologic models have been explored, secondary damage caused by continued inflammation and iron exposure from red blood cell lysis may explain poor outcomes at distant follow-up. Examining serum samples of patients with ICH for biomarkers of iron physiology may yield relationships between iron exposure and functional outcomes. Methods The following study retrospectively evaluated 41 patient serum samples obtained 1 day and 7 days post-ictus for CD163, ferritin, and hepcidin concentrations. Functional outcomes, using the modified Rankin Scale, were dichotomized into good (0-3) and poor (4-6). Correlation analysis and logistic regression were used to explore relationships between biomarker values, clinical metrics (such as ICH Score), and functional outcomes at 3 and 12 months. Results Clinical metrics (Acute Physiology and Chronic Health Evaluation II score, ICH Score, and National Institutes of Health Stroke Scale) were correlated with elevated ferritin levels 7 days post-ictus. Furthermore, it was found that mean CD163 levels on day 1 were significantly associated with functional outcomes at 3 and 12 months; mean serum ferritin concentrations on days 1 and 7 were elevated in those with poor outcomes at 3 months, and day 7 levels were independently correlated with 12-month outcomes. Conclusion Although this study serves to contribute to a growing body of evidence that CD163 and ferritin are biomarkers of functional outcomes, prospective cohort studies may clarify the role of iron-related inflammatory biomarkers as they pertain to neurological decline in patients with ICH.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2017.03.035