Article
Analysis of intrathecal interleukin-6 as a potential predictive factor for vasospasm in subarachnoid hemorrhage
Intrathekales IL-6: möglicher prädiktiver Faktor für Vasospasmen bei Subarachnoidalblutung
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Published: | April 11, 2007 |
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Objective: Inflammatory response seems to be one of the relevant pathophysiological aspects for developing vasospasm in subarachnoid hemorrhage (SAH). The probable diagnostic value of intrathecal proinflammatory markers is still unclear and is assessed in this study.
Methods: We analysed daily clinical data and laboratory tests of cerebrospinal fluid (CSF) of 64 patients with mostly poor-grade SAH over a period of 14 days. Special attention was given to the relationship between the development of vasospasm and the time course of the intrathecal interleukin 6 concentrations (IL-6CSF). The potential power of IL-6CSF for predicting vasospasm was studied.
Results: Vasospasm developed in 28.1% of patients with a mean onset of 6.4 days after bleeding as detected by conventional methods. Patients with vasospasm demonstrated statistically significant higher median values of IL-6CSF on days 4 and 5 (p<0.05 respectively). Most importantly, the increase of IL-6CSF preceded the conventional signs of vasospasm. A cut-off value of IL-6CSF≥2000 pg/ml on day 4 yielded an 11.72- higher relative risk (95% - CI: 2.93 - 46.60) of developing vasospasm, predicting vasospasm with a sensitivity of 88.9% and a specificity of 78.3%. We found a statistically significant correlation between IL-6CSF and delayed cerebral ischemia (DCI) for day 7 (p=0.03). However, there was no correlation with IL-6CSF on any other day and outcome.
Conclusions: IL-6CSF seems to be a reliable early marker for predicting vasospasm after SAH on days 4 and 5 before clinical onset.