Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months
Acute kidney injury (AKI) is a known predictor of unfavorable outcome in patients treated at the ICU, irrespective of the disease. However, data on the potential influence of serum creatinine (sCr) on hospital admission on the outcome in patients suffering from aneurysmal subarachnoid hemorrhage (SA...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/16/4753 |
| _version_ | 1797444432061005824 |
|---|---|
| author | Tim Lampmann Alexis Hadjiathanasiou Harun Asoglu Johannes Wach Tamara Kern Hartmut Vatter Erdem Güresir |
| author_facet | Tim Lampmann Alexis Hadjiathanasiou Harun Asoglu Johannes Wach Tamara Kern Hartmut Vatter Erdem Güresir |
| author_sort | Tim Lampmann |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a known predictor of unfavorable outcome in patients treated at the ICU, irrespective of the disease. However, data on the potential influence of serum creatinine (sCr) on hospital admission on the outcome in patients suffering from aneurysmal subarachnoid hemorrhage (SAH) is scarce. A total of 369 consecutive patients suffering from SAH were included in this retrospective cohort study. Patients were divided into good-grade (WFNS I–III) versus poor-grade (WFNS IV–V). Outcome was assessed according to the modified Rankin Scale (mRS) after 6 months and stratified into favorable (mRS 0–2) versus unfavorable (mRS 3–6). SAH patients with sCr levels <1.0 mg/dL achieved significantly a favorable outcome more often compared to patients with sCr levels ≥1.0 mg/dL (<i>p</i> = 0.003). In the multivariable analysis, higher levels of sCr (<i>p</i> = 0.014, OR 2.4; 95% CI 1.2–4.7), poor-grade on admission (<i>p</i> < 0.001, OR 9.8; 95% CI 5.6–17.2), age over 65 years (<i>p</i> < 0.001, OR 3.3; 95% CI 1.7–6.1), and delayed cerebral ischemia (<i>p</i> < 0.001, OR 7.9; 95% CI 3.7–17.1) were independently associated with an unfavorable outcome. We identified increased sCr on admission as a predictor for unfavorable functional outcome after SAH. Further studies elucidating the pathophysiology of this association are necessary. |
| first_indexed | 2024-03-09T13:11:32Z |
| format | Article |
| id | doaj.art-5544b097b6e74d8c878341696acfb6b3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T13:11:32Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5544b097b6e74d8c878341696acfb6b32023-11-30T21:40:54ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116475310.3390/jcm11164753Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 MonthsTim Lampmann0Alexis Hadjiathanasiou1Harun Asoglu2Johannes Wach3Tamara Kern4Hartmut Vatter5Erdem Güresir6Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, 53127 Bonn, GermanyAcute kidney injury (AKI) is a known predictor of unfavorable outcome in patients treated at the ICU, irrespective of the disease. However, data on the potential influence of serum creatinine (sCr) on hospital admission on the outcome in patients suffering from aneurysmal subarachnoid hemorrhage (SAH) is scarce. A total of 369 consecutive patients suffering from SAH were included in this retrospective cohort study. Patients were divided into good-grade (WFNS I–III) versus poor-grade (WFNS IV–V). Outcome was assessed according to the modified Rankin Scale (mRS) after 6 months and stratified into favorable (mRS 0–2) versus unfavorable (mRS 3–6). SAH patients with sCr levels <1.0 mg/dL achieved significantly a favorable outcome more often compared to patients with sCr levels ≥1.0 mg/dL (<i>p</i> = 0.003). In the multivariable analysis, higher levels of sCr (<i>p</i> = 0.014, OR 2.4; 95% CI 1.2–4.7), poor-grade on admission (<i>p</i> < 0.001, OR 9.8; 95% CI 5.6–17.2), age over 65 years (<i>p</i> < 0.001, OR 3.3; 95% CI 1.7–6.1), and delayed cerebral ischemia (<i>p</i> < 0.001, OR 7.9; 95% CI 3.7–17.1) were independently associated with an unfavorable outcome. We identified increased sCr on admission as a predictor for unfavorable functional outcome after SAH. Further studies elucidating the pathophysiology of this association are necessary.https://www.mdpi.com/2077-0383/11/16/4753subarachnoid hemorrhageintracranial aneurysmneurological outcomeserum creatininerenal functionrisk factor |
| spellingShingle | Tim Lampmann Alexis Hadjiathanasiou Harun Asoglu Johannes Wach Tamara Kern Hartmut Vatter Erdem Güresir Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months Journal of Clinical Medicine subarachnoid hemorrhage intracranial aneurysm neurological outcome serum creatinine renal function risk factor |
| title | Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months |
| title_full | Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months |
| title_fullStr | Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months |
| title_full_unstemmed | Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months |
| title_short | Early Serum Creatinine Levels after Aneurysmal Subarachnoid Hemorrhage Predict Functional Neurological Outcome after 6 Months |
| title_sort | early serum creatinine levels after aneurysmal subarachnoid hemorrhage predict functional neurological outcome after 6 months |
| topic | subarachnoid hemorrhage intracranial aneurysm neurological outcome serum creatinine renal function risk factor |
| url | https://www.mdpi.com/2077-0383/11/16/4753 |
| work_keys_str_mv | AT timlampmann earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT alexishadjiathanasiou earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT harunasoglu earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT johanneswach earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT tamarakern earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT hartmutvatter earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months AT erdemguresir earlyserumcreatininelevelsafteraneurysmalsubarachnoidhemorrhagepredictfunctionalneurologicaloutcomeafter6months |