The predictive value of inflammatory biomarkers on 30-day mortality in the neurological critical care setting

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Conference Proceeding

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Publication Title

Neurocrit Care


Introduction Prognostication is difficult for patients admitted to a neurocritical care unit (NCCU). Can serum biomarkers obtained as part of routine admission lab work help predict outcomes among patients expected to stay in the NCCU for >48 hours? Methods In this prospective cohort study, the following biomarkers were measured at admission: C-reactive protein (CRP), arterial lactate, neuron specific enolase (NSE), lactate dehydrogenase (LDH), albumin, and brain natriuretic peptide (BNP). We collected information about demographics, comorbidities, hospital procedures and complications and 30-day mortality. We compared these serological biomarkers in patients who were alive versus those who had died at 30 days. Results A total of 112 patients were enrolled over 4 months from June to September 2016, 11 of which whom (9.8%) died within 30 days of admission. There were no statistically significant differences in age or gender between the two groups. The 30-day mortality group had a higher mean Charlson Comorbidity Index (CCI) (3.0 vs 1.6, p=0.027) as well as mean NSE (39.1 vs 13.9 ug/L, p=0.008) and BNP levels (590.2 vs 177.3 pg/mL, p=0.003). Mean CRP, lactate, and LDH were also higher in the 30-day mortality group (79.5 vs 51.8 mg/L, 2.3 vs 1.9 mmol/L, and 307.2 vs 274.2 U/L) while mean albumin was lower (3.0 vs 3.3 g/dL), although these differences were not statistically significant (p<0.35). Conclusions CCI and serological biomarkers may have utility in predicting 30-day mortality among patients admitted to the NCCU. As we continue enrollment, we plan to develop a predictive model for 30-day mortality on admission for patients admitted to the NCCU using serological biomarkers, CCI and admission characteristics.





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