gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Time course of interleukin 6 levels in the CSF and serum of patients with subarachnoid haemorrhage and delayed cerebral ischemia – a single-centre experience

Vasopasmus in Patienten mit Subarachnoidalblutung und der zeitliche Verlauf von Interleukin 6 im Liquor und Serum – eine monozentrische Analyse

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Sami Ridwan - Evangelisches Klinikum Bethel, Neurochirurgie, Bielefeld, Deutschland
  • Zsolt Meszaros - Evangelisches Klinikum Bethel, Neurochirurgie, Bielefeld, Deutschland
  • Alexander Grote - Evangelisches Klinikum Bethel, Neurochirurgie, Bielefeld, Deutschland
  • Matthias Simon - Evangelisches Klinikum Bethel, Neurochirurgie, Bielefeld, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP018

doi: 10.3205/19dgnc356, urn:nbn:de:0183-19dgnc3563

Veröffentlicht: 8. Mai 2019

© 2019 Ridwan et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: To study the time course of serum and cerebrospinal fluid (CSF) interleukin 6 (IL-6) levels in patients with subarachnoid hemorrhage (SAH) in correlation to delayed cerebral ischemia (DCI) and vasospasm related ischemia.

Methods: We enrolled 57 consecutive patients requiring external CSF drainage treated in our hospital for SAH between 1/2016 and 3/2018. Serum and CSF IL-6 levels (pg/ml) were recorded for up to 45 days. Data were tested for possible correlation with the occurrence of DCI, with vasospastic infarction, meningitis and the patients’ clinical outcome. DCI was defined as secondary blood-pressure dependent neurological impairment and/or imaging evidence of vasospastic infarction. Outcomes were assessed using the modified Rankin scale (mRS). Statistical analysis was performed using standard methods.

Results: 27 male and 30 females (median age 57 yrs.) were included in this analysis. IL-6 levels were available for all patients. Highest CSF IL-6 levels were measured at days 6-8 following SAH. The mean maximum CSF level was 21352±21592 pg/ml (day 1-3: 2802±6352 pg/ml). The mean maximum serum IL-6 level was 325±687 pg/ml. Serum levels peaked between days 2-8. Mean maximum CSF IL-6 values correlated significantly with the occurrence of DCI (P=0.006), infarction (P=0.002) and adverse outcome (mRS 3-6 vs. 0-2; P=0.005). These correlations remained statistically significant for DCI and infarction after subtracting the initial day 1-3 IL-6 values (P=0.003 & 0.009) and also when using the median as a cut-off (P=0.003 & 0.016). ROC analysis for CSF peak values excluding day 1-3 results were as follows: AUC 0.762; sensitivity 90% & specificity 40% for cut-off 6000 pg/ml. Mean maximum IL-6 CSF levels did not vary significantly between patients with and without meningitis. Serum IL-6 levels and serum/CSF level ratios were not associated with DCI, vasospastic infarction or outcome.

Conclusion: CSF IL-6 levels after SAH follow a characteristic and consistent time course with highest values at day 6-8. Peak CSF levels correlate strongly with DCI, infarction and outcome. However, due to low specificity the overall diagnostic potential of IL-6 CSF levels seems limited.