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Venous and Arterial TNF-R1 Predicts Outcome and Complications in Acute Subarachnoid Hemorrhage

2019Journal article Open access
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dc.contributor.authorFragata, I
dc.contributor.authorBustamante, A
dc.contributor.authorPenalba, A
dc.contributor.authorFerreira, P
dc.contributor.authorPaiva Nunes, A
dc.contributor.authorCanhão, P
dc.contributor.authorMontaner, J
dc.date.accessioned2021-02-16T17:19:45Z
dc.date.available2021-02-16T17:19:45Z
dc.date.issued2019
dc.description.abstractBackground: There is increasing evidence for the role of inflammation in clinical outcome after subarachnoid hemorrhage (SAH). Specifically, the TNF-alfa(α) pathway seems to be relevant after SAH. Although the TNF-α main receptor, TNF-R1 is associated with aneurysm growth and rupture, its relation to prognosis is unknown. We sought to compare TNF-R1 levels in peripheral venous blood and arterial blood closer to the ruptured aneurysm to study the association of TNF-R1 blood levels with poor prognosis (modified Rankin Scale > 2 at discharge, 3 and 6 months) and complications (hydrocephalus or delayed cerebral ischemia/DCI) following SAH. Methods: We included consecutive SAH patients admitted in the first 72 h of symptoms. Blood samples were simultaneously collected from a peripheral vein and from the main parent artery of the aneurysm. Levels of TNF-R1 were measured using enzyme-linked immunosorbent assays. Results: We analyzed 58 patients. Arterial and venous levels of TNF-R1 were correlated (R = 0.706, p < 0.001). In multivariate regression analysis, venous TNF-R1 was an independent predictor of poor outcome at 6 months after adjusting by age and sex [odds ratio (OR) 11.63; 95% CI 2.09-64.7, p = 0.005] and after adjusting by Glasgow Coma Scale and Fisher scales (OR 8.74; 95% CI 1.45-52.7, p = 0.018). There was no association of TNF-R1 with DCI. A cut-off for arterial TNF-R1 of 1523.7 pg/mL had 75% sensitivity/66% specificity for the prediction of hydrocephalus. Conclusion: Levels of venous TNF-R1 are associated with poor outcome in SAH. A specific association was found between levels of arterial TNF-R1 and hydrocephalus. These results are consistent with the role of TNF-α pathway in SAH and need to be validated in larger cohorts.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNeurocrit Care. 2019 Aug;31(1):107-115.pt_PT
dc.identifier.doi10.1007/s12028-019-00669-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3572
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectArteriespt_PT
dc.subjectCohort Studiespt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectROC Curvept_PT
dc.subjectReceptors, Tumor Necrosis Factor, Type Ipt_PT
dc.subjectSubarachnoid Hemorrhagept_PT
dc.subjectTreatment Outcomept_PT
dc.subjectVeinspt_PT
dc.subjectHSJ NRADpt_PT
dc.titleVenous and Arterial TNF-R1 Predicts Outcome and Complications in Acute Subarachnoid Hemorrhagept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage115pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage107pt_PT
oaire.citation.titleNeurocritical Carept_PT
oaire.citation.volume31pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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