Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage
Cerebrospinal fluid (CSF) metabolites are increasingly recognized as prognostic factors in aneurysmal subarachnoid hemorrhage (SAH). The CSF arginine/ornithine ratio (Arg/Orn) was shown to predict cerebral vasospasms and clinical outcome in SAH. The additive prognostic value of Arg/Orn over establis...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1156505/full |
| _version_ | 1797847212984631296 |
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| author | Johannes Weller Tim Lampmann Harun Asoglu Matthias Schneider Stefan Felix Ehrentraut Felix Lehmann Erdem Güresir Franziska Dorn Gabor C. Petzold Gabor C. Petzold Hartmut Vatter Julian Zimmermann |
| author_facet | Johannes Weller Tim Lampmann Harun Asoglu Matthias Schneider Stefan Felix Ehrentraut Felix Lehmann Erdem Güresir Franziska Dorn Gabor C. Petzold Gabor C. Petzold Hartmut Vatter Julian Zimmermann |
| author_sort | Johannes Weller |
| collection | DOAJ |
| description | Cerebrospinal fluid (CSF) metabolites are increasingly recognized as prognostic factors in aneurysmal subarachnoid hemorrhage (SAH). The CSF arginine/ornithine ratio (Arg/Orn) was shown to predict cerebral vasospasms and clinical outcome in SAH. The additive prognostic value of Arg/Orn over established prognostic scores has not been investigated. CSF Arg/Orn and the established prognostic scores SAH, FRESH, SAH-PDS, HAIR, Rosen–McDonald, Hunt and Hess, WFNS and modified Fisher scale were determined in a prospective cohort of patients with aneurysmal SAH. Logistic regression models to predict a favorable outcome, defined as a modified Rankin Scale score of 0–3 at 3 months follow-up, were constructed for each score, both with and without the addition of Arg/Orn. The impact of Arg/Orn was assessed comparing logistic regression models containing the respective score with and without Arg/Orn with the likelihood ratio chi-squared test. CSF Arg/Orn and clinical scores were determined in 38 SAH patients. Arg/Orn was an independent predictor of clinical outcome when added to established prognostic scores (p < 0.05) with the exception of HAIR (p = 0.078). All models were significantly improved if Arg/Orn was added as a covariable (p < 0.05). The results of this study confirm Arg/Orn as an independent prognostic factor and its addition improves established prognostic models in SAH. |
| first_indexed | 2024-04-09T18:08:44Z |
| format | Article |
| id | doaj.art-2d7e77db2f554064971de5fe310dfc2e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T18:08:44Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-2d7e77db2f554064971de5fe310dfc2e2023-04-14T04:51:38ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11565051156505Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhageJohannes Weller0Tim Lampmann1Harun Asoglu2Matthias Schneider3Stefan Felix Ehrentraut4Felix Lehmann5Erdem Güresir6Franziska Dorn7Gabor C. Petzold8Gabor C. Petzold9Hartmut Vatter10Julian Zimmermann11Department of Neurology, University Hospital Bonn, Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Bonn, GermanyDepartment of Anesthesiology, University Hospital Bonn, Bonn, GermanyDepartment of Anesthesiology, University Hospital Bonn, Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Bonn, GermanyDepartment of Neuroradiology, University Hospital Bonn, Bonn, GermanyDepartment of Neurology, University Hospital Bonn, Bonn, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Bonn, GermanyDepartment of Neurology, University Hospital Bonn, Bonn, GermanyCerebrospinal fluid (CSF) metabolites are increasingly recognized as prognostic factors in aneurysmal subarachnoid hemorrhage (SAH). The CSF arginine/ornithine ratio (Arg/Orn) was shown to predict cerebral vasospasms and clinical outcome in SAH. The additive prognostic value of Arg/Orn over established prognostic scores has not been investigated. CSF Arg/Orn and the established prognostic scores SAH, FRESH, SAH-PDS, HAIR, Rosen–McDonald, Hunt and Hess, WFNS and modified Fisher scale were determined in a prospective cohort of patients with aneurysmal SAH. Logistic regression models to predict a favorable outcome, defined as a modified Rankin Scale score of 0–3 at 3 months follow-up, were constructed for each score, both with and without the addition of Arg/Orn. The impact of Arg/Orn was assessed comparing logistic regression models containing the respective score with and without Arg/Orn with the likelihood ratio chi-squared test. CSF Arg/Orn and clinical scores were determined in 38 SAH patients. Arg/Orn was an independent predictor of clinical outcome when added to established prognostic scores (p < 0.05) with the exception of HAIR (p = 0.078). All models were significantly improved if Arg/Orn was added as a covariable (p < 0.05). The results of this study confirm Arg/Orn as an independent prognostic factor and its addition improves established prognostic models in SAH.https://www.frontiersin.org/articles/10.3389/fneur.2023.1156505/fullsubarachnoid hemorrhageoutcome prognosticationornithine (PubChem CID: 6262)arginine (PubChem CID: 6322)scores accuracycerebrospinal fluid |
| spellingShingle | Johannes Weller Tim Lampmann Harun Asoglu Matthias Schneider Stefan Felix Ehrentraut Felix Lehmann Erdem Güresir Franziska Dorn Gabor C. Petzold Gabor C. Petzold Hartmut Vatter Julian Zimmermann Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage Frontiers in Neurology subarachnoid hemorrhage outcome prognostication ornithine (PubChem CID: 6262) arginine (PubChem CID: 6322) scores accuracy cerebrospinal fluid |
| title | Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| title_full | Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| title_fullStr | Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| title_full_unstemmed | Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| title_short | Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| title_sort | additive prognostic impact of the cerebrospinal fluid arginine ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage |
| topic | subarachnoid hemorrhage outcome prognostication ornithine (PubChem CID: 6262) arginine (PubChem CID: 6322) scores accuracy cerebrospinal fluid |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1156505/full |
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