Emergency department point‑of‑care biomarkers and day 90 functional outcome in spontaneous intracerebral hemorrhage: A single‑center pilot study

Mureșan,Eugenia-Maria; Golea,Adela; Vesa,Ștefan Cristian; Lenghel,Manuela; Csutak,Csaba; Perju‑Dumbravă,Lăcrămioara

doi:10.3892/etm.2022.11123

Emergency department point‑of‑care biomarkers and day 90 functional outcome in spontaneous intracerebral hemorrhage: A single‑center pilot study

Authors:
- Eugenia-Maria Mureșan
- Adela Golea
- Ștefan Cristian Vesa
- Manuela Lenghel
- Csaba Csutak
- Lăcrămioara Perju‑Dumbravă
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Affiliations: Department of Neurosciences, Faculty of Medicine, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania, Department of Surgery, Emergency Medicine Discipline, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400006 Cluj‑Napoca, Romania, Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, ‘Iuliu Haţieganu’ University of Medicine and Pharmacy, 400349 Cluj‑Napoca, Romania, Department of Surgical Specialties, Radiology Discipline, ‘Iuliu Hațieganu’, University of Medicine and Pharmacy, 400162 Cluj‑Napoca, Romania
Published online on: January 5, 2022 https://doi.org/10.3892/etm.2022.11123
Article Number: 200
Copyright: © Mureșan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Spontaneous intracerebral hemorrhage (sICH) results in high morbidity and mortality rates, thus identifying strategies for timely prognosis and treatment is important. The present study aimed to analyze the relationship between emergency department point‑of‑care (POC) blood biomarkers and day 90 functional outcome (FO) in patients with acute (<8 h) sICH. On‑site POC determinations, including complete blood count, glucose, cardiac troponin I, D‑dimer and C‑reactive protein, and derived inflammatory indexes were performed for a cohort of 35 patients. The primary endpoint was a favorable day 90 FO (modified Rankin Score ≤3). Secondary endpoints included early neurological worsening (ENW), day 7/discharge neurological impairment, day 90 independence assessment (Barthel Index <60), hematoma enlargement and perihematomal edema (PHE) growth. A favorable three‑month FO was reported in 16 (46%) participants. Older age, previous history of ischemic stroke and initial imagistic parameters, including intraventricular hemorrhage, enlarged contralateral ventricle and cerebral atrophy, significantly predicted an unfavorable FO. The admission D‑dimer similarly predicted day 90 FO and the independence status, along with ENW and a more severe day 7/discharge neurological status. The D‑dimer also correlated with the initial neurological status and PHE. PHE growth correlated with granulocytes, systemic immune‑inflammation index and glycemia. The results suggested that a lower admission D‑dimer could indicate an improved day 90 FO of patients with sICH, while also anticipating the development of PHE growth and ENW.

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