4.5 Article

High serum levels of TAC and early mortality in patients with spontaneous intracerebral haemorrhage

Journal

NEUROLOGICAL SCIENCES
Volume 42, Issue 4, Pages 1491-1497

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-020-04692-z

Keywords

Spontaneous intracerebral haemorrhage; Total antioxidant capacity; Apoptosis; Patients; Mortality

Funding

  1. Instituto de Salud Carlos III (Madrid, Spain) [PI-18-00500]
  2. Fondo Europeo de Desarrollo Regional (FEDER)

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The study aimed to investigate the relationship between serum TAC levels and mortality in patients with SIH. The findings showed that non-surviving patients had higher serum TAC levels than surviving patients, and that these levels were associated with mortality.
Objective Oxidation contributes to secondary brain injury after spontaneous intracerebral haemorrhage (SIH). One study found lower levels of total antioxidant capacity (TAC) in the blood in patients with SIH than in healthy subjects. However, there are no data on blood TAC levels and survival in patients with SIH. Therefore, the objective of our study was to determine if an association exists between serum TAC levels and mortality in patients with SIH. Methods We included patients with severe supratentorial SIH. We considered severe when Glasgow Coma Scale (GCS) < 9. Patients from 6 Spanish hospitals were included in this observational and prospective study. Serum TAC levels at days 1, 4 and 8 of SIH were determined. Thirty-day mortality was our end-point study. Results Non-surviving patients compared with surviving patients showed higher serum TAC levels at day 1 (p < 0.001), 4 (p < 0.001) and 8 (p = 0.001). An area under the curve was found for the prediction of 30-day mortality by serum TAC levels of 0.92 (95% CI = 0.85-96%;p < 0.001). Multiple logistic regression analysis showed an association of serum TAC levels with 30-day mortality (odds ratio = 16.513; 95% CI = 2.548-107.015;p = 0.003) controlling for midline shift, glycemia, early evacuation of SIH, intracerebral haemorrhage (ICH) score, age and volume of SIH. Conclusions The new findings of this study are that serum TAC levels are higher in non-surviving than in surviving patients, and that they are associated with mortality and could be used to predict mortality.

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