Universität zu Köln

Zhang, Yi-Bin, Zheng, Feng, Stavrinou, Lampis, Wang, Hao-Jie, Fan, Wen-Jian, Yao, Pei-Sen ORCID: 0000-0003-3313-6302, Lin, Yuan-Xiang, Goldbrunner, Roland, Zheng, Shu-Fa, Stavrinou, Pantelis and Kang, De-Zhi (2022). Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis. Brain Sci., 12 (9). BASEL: MDPI. ISSN 2076-3425

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Abstract

This study aimed to investigate the association between serum iron (SI) and postoperative delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). We retrospectively analyzed 985 consecutive adult patients diagnosed with aSAH. Demographic, clinical, and laboratory data were recorded. Univariate and multivariate analyses were employed to assess the association between SI and DCI. Propensity-score matching (PSM) analysis was implemented to reduce confounding. Postoperative DCI developed in 14.38% of patients. Lower SI upon admission was detected in aSAH patients with severe clinical conditions and severe aSAH. SI was negatively correlated with WFNS grade (r = -0.3744, p < 0.001) and modified Fisher (mFisher) grade (r = -0.2520, p < 0.001). Multivariable analysis revealed lower SI was independently associated with DCI [odds ratios (OR) 0.281, 95% confidence interval (CI) 0.177-0.448, p < 0.001], while WFNS grade and mFisher grade were not. The receiver-operating characteristics (ROC) curve analysis of SI for DCI gave an area under the curve (AUC) of 0.7 and an optimal cut-off of 7.5 mu mol/L (95% CI 0.665 to 0.733, p < 0.0001). PSM demonstrated the DCI group had a significantly lower SI than the non-DCI group (10.91 +/- 6.86 vs. 20.34 +/- 8.01 mu mol/L, p < 0.001). Lower SI remained a significant independent predictor for DCI and an independent poor prognostic factor of aSAH in multivariate analysis (OR 0.363, 95% CI 0.209-0.630, p < 0.001). The predictive performance of SI for poor outcome had a corresponding AUC of 0.718 after PSM. Lower SI upon admission is significantly associated with WFNS grade, mFisher grade, and predicts postoperative DCI and poor outcome at 90 days following aSAH.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zhang, Yi-Bin UNSPECIFIED UNSPECIFIED UNSPECIFIED Zheng, Feng UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Lampis UNSPECIFIED UNSPECIFIED UNSPECIFIED Wang, Hao-Jie UNSPECIFIED UNSPECIFIED UNSPECIFIED Fan, Wen-Jian UNSPECIFIED UNSPECIFIED UNSPECIFIED Yao, Pei-Sen UNSPECIFIED orcid.org/0000-0003-3313-6302 UNSPECIFIED Lin, Yuan-Xiang UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Zheng, Shu-Fa UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Pantelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Kang, De-Zhi UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-677021
DOI:	10.3390/brainsci12091183
Journal or Publication Title:	Brain Sci.
Volume:	12
Number:	9
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2076-3425
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRAIN-INJURY; METABOLISM; OUTCOMES; BLOOD; INFLAMMATION; HEALTHY Multiple languages Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67702