Highlights
- •Changes in serum S100B levels interacted with DCI occurrence after aSAH.
- •S100B concentration on day 3 following aSAH may predict DCI.
- •Worse cerebral autoregulation and elevated S100B increase the risk of DCI.
- •Monitoring of biomarkers and cerebral autoregulation support a prediction of DCI.
Abstract
Background
Identifying patients at risk of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid
haemorrhage (aSAH) remains challenging. This study aimed to evaluate the concentration
of serum biomarkers along with cerebral autoregulation impairment on DCI.
Methods
55 patients suffering from aSAH were enrolled in the study. Serum S100 protein B (S100B) was tested both on the day of admission and over three consecutive
days following the occurrence of aSAH. Cerebral autoregulation was assessed using
a tissue oxygenation index (TOxa) based on near-infrared spectroscopy.
Results
Changes in serum S100B levels interacted with DCI status (presence vs. absence): F = 3.84, p = 0.016. Patients with DCI had higher S100B concentration level on day 3 than those
without DCI (3.54 ± 0.50 ng/ml vs. 0.58 ± 0.43 ng/ml, p = 0.001). S100B concentration on day 3 following aSAH predicted DCI (AUC = 0.77,
p = 0.006). Raised level of serum S100B on day 3 was related with higher TOxa, thus
with impaired cerebral autoregulation (rS = 0.52, p = 0.031). Multivariate logistic regression analysis showed that impaired cerebral autoregulation and elevated S100B concentration on day 3 increase the likelihood of DCI.
Conclusions
Tracking changes in the serum biomarkers concentration along with monitoring of cerebral
autoregulation, may play a role in early detection of patients at risk of DCI after
aSAH. These results need to be validated in larger prospective cohorts.
Keywords
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Article info
Publication history
Accepted:
February 6,
2021
Received:
December 17,
2020
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
