Mortality of spontaneous intracerebral haemorrhage patients and high serum caspase-8 concentrations

Purpose: Apoptotic changes in brain samples have been found in haematoma areas of patients with spontaneous intracerebral haemorrhage (SIH) undergoing surgical haematoma evacuation. However, circulating caspase-8 concentrations in SIH patients have not been described. Thus, we carried out this study with the aim to explore whether there is an association of circulating caspase-8 concentrations and mortality in patients with SIH. Methods: We included patients with severe and supratentorial SIH. We established that the SIH was severe if Glasgow Coma Scale (GCS) was lower than 9. Intensive Care Units from 5 Spanish hospitals carried out the recruitment of patients of this observational and prospective study. We registered serum caspase-8 levels at moment of severe SIH diagnosis and 30-day mortality. Results: Surviving (n = 41) in respect to non-surviving SIH patients (n = 38) showed lower serum caspase-8 levels (p < 0.001). The area under the curve to estimate 30-day mortality ability by serum caspase-8 levels was 0.75 (95% CI = 0.64-86; p < 0.001). Kaplan-Meier analysis found that patients with serum caspase-8 levels > 17.8 ng/mL showed higher death risk (Hazard ratio = 3.9; 95% CI = 1.99-7.63; p < 0.001). Multiple logistic regression analysis revealed the association of serum caspase-8 concentrations (controlling for intracerebral haemorrhage score, midline shift and early haematoma evacuation) with mortality at 30 days (Odds Ratio = 1.048; 95% CI = 1.018-1.079; p = 0.002). Conclusions: The association of serum caspase-8 concentrations with mortality of SIH patient mortality is the main of novel findings that have been revealed in our study. (C) 2021 Socie acute accent te acute accent franc , aise d'anesthe acute accent sie et de re acute accent animation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Automated summary

This study aimed to explore the association between circulating caspase-8 concentrations and mortality in patients with spontaneous intracerebral hemorrhage (SIH). The results indicated that surviving SIH patients had lower serum caspase-8 levels compared to non-survivors, with higher serum caspase-8 levels associated with increased risk of death. Multiple logistic regression analysis revealed a significant association of serum caspase-8 concentrations with mortality at 30 days. The findings suggest that serum caspase-8 concentrations may be a novel predictor of mortality in SIH patients.