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Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study

Background: Brain natriuretic peptide serum levels (BNP) on admission are frequently elevated in patients with symptomatic chronic subdural hematoma (cSDH) and predict unfavorable long-term functional outcomes. However, the reasons for these elevated levels remain unclear. Therefore, we aimed to ide...

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Autores principales: Chihi, Mehdi, Jabbarli, Ramazan, Parlak, Ahmet, Darkwah-Oppong, Marvin, Gembruch, Oliver, Wrede, Karsten Henning, Sure, Ulrich, Maslehaty, Homajoun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073232/
https://www.ncbi.nlm.nih.gov/pubmed/33924048
http://dx.doi.org/10.3390/jcm10081791
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author Chihi, Mehdi
Jabbarli, Ramazan
Parlak, Ahmet
Darkwah-Oppong, Marvin
Gembruch, Oliver
Wrede, Karsten Henning
Sure, Ulrich
Maslehaty, Homajoun
author_facet Chihi, Mehdi
Jabbarli, Ramazan
Parlak, Ahmet
Darkwah-Oppong, Marvin
Gembruch, Oliver
Wrede, Karsten Henning
Sure, Ulrich
Maslehaty, Homajoun
author_sort Chihi, Mehdi
collection PubMed
description Background: Brain natriuretic peptide serum levels (BNP) on admission are frequently elevated in patients with symptomatic chronic subdural hematoma (cSDH) and predict unfavorable long-term functional outcomes. However, the reasons for these elevated levels remain unclear. Therefore, we aimed to identify the predictors of BNP elevation. Methods: Patients with unilateral symptomatic cSDH who were surgically treated in our department between November 2016 and May 2020 were enrolled. Patients’ symptoms and neurological deficits were prospectively assessed using a study questionnaire. On initial computer tomography, hematoma volumes and midline shift (MLS) values were measured to analyze the degree of brain compression. Results: In total, 100 patients were analyzed. Linear regression analysis showed that higher BNP levels were significantly associated with smaller hematoma volumes (p = 0.003) and littler MLS values (p = 0.022). Multivariate analysis revealed that presence of a neurological deficit (p = 0.041), a hematoma volume < 140 mL (p = 0.047), advanced age (p = 0.023), and head trauma within 24 h of admission (p = 0.001) were independent predictors of BNP elevation. Conclusion: In symptomatic cSDH, BNP elevation is related, among others, to the presence of neurological deficits and smaller hematoma volumes. Whether BNP elevation may coincide with the early stage of hematoma growth, i.e., immaturity of cSDH neomembrane, requires further investigations.
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spelling pubmed-80732322021-04-27 Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study Chihi, Mehdi Jabbarli, Ramazan Parlak, Ahmet Darkwah-Oppong, Marvin Gembruch, Oliver Wrede, Karsten Henning Sure, Ulrich Maslehaty, Homajoun J Clin Med Article Background: Brain natriuretic peptide serum levels (BNP) on admission are frequently elevated in patients with symptomatic chronic subdural hematoma (cSDH) and predict unfavorable long-term functional outcomes. However, the reasons for these elevated levels remain unclear. Therefore, we aimed to identify the predictors of BNP elevation. Methods: Patients with unilateral symptomatic cSDH who were surgically treated in our department between November 2016 and May 2020 were enrolled. Patients’ symptoms and neurological deficits were prospectively assessed using a study questionnaire. On initial computer tomography, hematoma volumes and midline shift (MLS) values were measured to analyze the degree of brain compression. Results: In total, 100 patients were analyzed. Linear regression analysis showed that higher BNP levels were significantly associated with smaller hematoma volumes (p = 0.003) and littler MLS values (p = 0.022). Multivariate analysis revealed that presence of a neurological deficit (p = 0.041), a hematoma volume < 140 mL (p = 0.047), advanced age (p = 0.023), and head trauma within 24 h of admission (p = 0.001) were independent predictors of BNP elevation. Conclusion: In symptomatic cSDH, BNP elevation is related, among others, to the presence of neurological deficits and smaller hematoma volumes. Whether BNP elevation may coincide with the early stage of hematoma growth, i.e., immaturity of cSDH neomembrane, requires further investigations. MDPI 2021-04-20 /pmc/articles/PMC8073232/ /pubmed/33924048 http://dx.doi.org/10.3390/jcm10081791 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chihi, Mehdi
Jabbarli, Ramazan
Parlak, Ahmet
Darkwah-Oppong, Marvin
Gembruch, Oliver
Wrede, Karsten Henning
Sure, Ulrich
Maslehaty, Homajoun
Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title_full Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title_fullStr Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title_full_unstemmed Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title_short Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
title_sort predictors of brain natriuretic peptide serum level elevation in patients with symptomatic chronic subdural hematoma: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073232/
https://www.ncbi.nlm.nih.gov/pubmed/33924048
http://dx.doi.org/10.3390/jcm10081791
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