Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: Correlation with infection and long-term outcome

Azurmendi, L; Degos, V; Tiberti, N; Kapandji, N; Sanchez-Peña, P; Sarrafzadeh, A; Puybasset, L; Turck, N; Sanchez, JC

Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: Correlation with infection and long-term outcome

Azurmendi, L Degos, V Tiberti, N

Kapandji, N Sanchez-Peña, P Sarrafzadeh, A Puybasset, L Turck, N Sanchez, JC

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Publication Type:: Journal Article
Citation:: Journal of Neurosurgery, 2016, 124 (5), pp. 1287 - 1299
Issue Date:: 2016-05-01

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Field	Value	Language
dc.contributor.author	Azurmendi, L	en_US
dc.contributor.author	Degos, V	en_US
dc.contributor.author	Tiberti, N https://orcid.org/0000-0002-2981-5233	en_US
dc.contributor.author	Kapandji, N	en_US
dc.contributor.author	Sanchez-Peña, P	en_US
dc.contributor.author	Sarrafzadeh, A	en_US
dc.contributor.author	Puybasset, L	en_US
dc.contributor.author	Turck, N	en_US
dc.contributor.author	Sanchez, JC	en_US
dc.date.issued	2016-05-01	en_US
dc.identifier.citation	Journal of Neurosurgery, 2016, 124 (5), pp. 1287 - 1299	en_US
dc.identifier.issn	0022-3085	en_US
dc.identifier.uri	http://hdl.handle.net/10453/101532
dc.description.abstract	© AANS, 2016. Objective Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of mortality and morbidity. The main predictor for the poor outcome is the World Federation of Neurosurgical Societies (WFNS) scale. However, this scale does not take into account proinflammatory events, such as infection occurring after the aSAH, which could modify the long-term status of patients. The aim of this study was to evaluate neopterin as an inflammatory biomarker for outcome and infection prediction in aSAH patients. Methods Plasma concentrations of neopterin were measured in 61 aSAH patients (22 male and 39 female; mean age [± SD] 52.8 ± 11.8 years) using a commercial ELISA kit. Samples were collected daily for 10 days. Outcome at 12 months was determined using the Glasgow Outcome Scale (GOS) and dichotomized as poor (GOS score 1, 2, or 3) or good (GOS score 4 or 5). Infection was determined by the presence of a positive bacterial culture. Results Patients with poor outcome at 12 months had higher concentrations of neopterin than patients with good outcome. In the same way, patients who had an infection during the hospitalization had significantly higher concentrations of neopterin than patients without infection (p = 0.001). Moreover, neopterin concentrations were significantly (p < 0.008) elevated in infected patients 2 days before infection detection and antibiotic therapy. Conclusions Neopterin is an efficient outcome predictor after aSAH. Furthermore, it is able to differentiate between infected and uninfected patients as early as 2 days before clinical signs of infection, facilitating earlier antibiotic therapy and better management.	en_US
dc.relation.ispartof	Journal of Neurosurgery	en_US
dc.relation.isbasedon	10.3171/2015.3.JNS142212	en_US
dc.subject.classification	Neurology & Neurosurgery	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Bacterial Infections	en_US
dc.subject.mesh	Subarachnoid Hemorrhage	en_US
dc.subject.mesh	Neopterin	en_US
dc.subject.mesh	Inflammation Mediators	en_US
dc.subject.mesh	Enzyme-Linked Immunosorbent Assay	en_US
dc.subject.mesh	Glasgow Outcome Scale	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Outcome Assessment (Health Care)	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Statistics as Topic	en_US
dc.subject.mesh	S100 Calcium Binding Protein beta Subunit	en_US
dc.subject.mesh	Outcome Assessment, Health Care	en_US
dc.title	Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: Correlation with infection and long-term outcome	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	124	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1109 Neurosciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	open_access
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	124	en_US

Abstract:

© AANS, 2016. Objective Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of mortality and morbidity. The main predictor for the poor outcome is the World Federation of Neurosurgical Societies (WFNS) scale. However, this scale does not take into account proinflammatory events, such as infection occurring after the aSAH, which could modify the long-term status of patients. The aim of this study was to evaluate neopterin as an inflammatory biomarker for outcome and infection prediction in aSAH patients. Methods Plasma concentrations of neopterin were measured in 61 aSAH patients (22 male and 39 female; mean age [± SD] 52.8 ± 11.8 years) using a commercial ELISA kit. Samples were collected daily for 10 days. Outcome at 12 months was determined using the Glasgow Outcome Scale (GOS) and dichotomized as poor (GOS score 1, 2, or 3) or good (GOS score 4 or 5). Infection was determined by the presence of a positive bacterial culture. Results Patients with poor outcome at 12 months had higher concentrations of neopterin than patients with good outcome. In the same way, patients who had an infection during the hospitalization had significantly higher concentrations of neopterin than patients without infection (p = 0.001). Moreover, neopterin concentrations were significantly (p < 0.008) elevated in infected patients 2 days before infection detection and antibiotic therapy. Conclusions Neopterin is an efficient outcome predictor after aSAH. Furthermore, it is able to differentiate between infected and uninfected patients as early as 2 days before clinical signs of infection, facilitating earlier antibiotic therapy and better management.

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http://hdl.handle.net/10453/101532