Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?

J Stroke Cerebrovasc Dis. 2017 May;26(5):1007-1012. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.129. Epub 2017 Jan 24.

Abstract

Background: Several studies showed a correlation between C-reactive protein and mortality in spontaneous intracerebral hemorrhage. However, the best time to measure C-reactive protein to assess prognosis is not yet clear. The purpose of this study was to determine if initial or H24-C-reactive protein is independently associated with 30-day mortality in intracerebral hemorrhage.

Methods: This is a retrospective study done within years 2010-2015. All intracerebral hemorrhage cases with missing data or with autoimmune disease or neoplasm were excluded. Univariate and multivariate analyses were assessed for initial C-reactive protein, H24-C-reactive protein, and confounding factors.

Results: Of 122 patients, 91 were selected. Only H24-C-reactive protein, hematoma volume, and infratentorial origin were independently associated with 30-day mortality in intracerebral hemorrhage. When adjusted with intracerebral hemorrhage score, H24-C-reactive protein with a cutoff value of 30 mg/L independently predicted 30-day mortality.

Conclusions: This study suggests that H24-C-reactive protein may be a more reliable marker than initial C-reactive protein in the prediction of mortality in intracerebral hemorrhage. A large multicentric study is necessary to confirm the interest of including H24-C-reactive protein to a modified intracerebral hemorrhage score for the prediction of 30-day mortality.

Keywords: C-reactive protein; Intracerebral hemorrhage; inflammation; mortality; prognosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Cerebral Hemorrhage / blood*
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers
  • C-Reactive Protein