Abstract
IntroductionLower gelsolin levels have been associated with the severity and poor outcome of critical illness. Nevertheless, their link with clinical outcomes of aneurysmal subarachnoid hemorrhage is unknown. Therefore, we aimed to investigate the relationship between plasma gelsolin levels and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage.MethodsA total of 262 consecutive patients and 150 healthy subjects were included. Plasma gelsolin levels were measured by enzyme-linked immunosorbent assay. Mortality and poor long-term outcome (Glasgow Outcome Scale score of 1-3) at 6 months were recorded.ResultsPlasma gelsolin levels on admission were substantially lower in patients than in healthy controls (66.9 (26.4) mg/L vs. 126.4 (35.4) mg/L, P < 0.001), and negatively associated with World Federation of Neurological Surgeons score (r = -0.554, P < 0.001) and Fisher score (r = -0.538, P < 0.001), and identified as an independent predictor of poor functional outcome (odds ratio, 0.957; 95% confidence interval (CI), 0.933-0.983; P = 0.001) and death (odds ratio, 0.953; 95% CI, 0.917-0.990; P = 0.003) after 6 months. The areas under the ROC curve of gelsolin for functional outcome and mortality were similar to those of World Federation of Neurological Surgeons score and Fisher score (all P > 0.05). Gelsolin improved the predictive values of World Federation of Neurological Surgeons score and Fisher score for functional outcome (both P < 0.05), but not for mortality (both P > 0.05).ConclusionsGelsolin levels are a useful, complementary tool to predict functional outcome and mortality 6 months after aneurysmal subarachnoid hemorrhage.
Highlights
Lower gelsolin levels have been associated with the severity and poor outcome of critical illness
Study population characteristics During the recruitment period, 308 patients were admitted with an initial diagnosis of aneurysmal subarachnoid hemorrhage (SAH), 269 (87.3%) patients fulfilled the inclusion criteria and exclusion criteria, and adequate data on admission and follow-up were available for 262 individuals (112 men and 150 women) (85.1%) who were included in the analysis
In this post hoc analysis of prospective collected data, we demonstrated that plasma gelsolin levels on admission in the patients were significantly lower than those in healthy controls; and in patients who had poor functional outcome or died in 6 months, the gelsolin levels on admission were significantly lower compared with levels in survivors or those with good functional outcome
Summary
Lower gelsolin levels have been associated with the severity and poor outcome of critical illness. Their link with clinical outcomes of aneurysmal subarachnoid hemorrhage is unknown. We aimed to investigate the relationship between plasma gelsolin levels and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage. Plasma gelsolin is associated with the severity and outcome of critical illness, and has been proposed as a prognostic marker in acute illness [2,3,4,5,6,7,8,9,10,11]. Gelsolin has been found to be depleted in the peripheral blood of patients with aneurysmal subarachnoid
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