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Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis

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 we...

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Detalles Bibliográficos
Autores principales: Zhang, Yi-Bin, Zheng, Feng, Stavrinou, Lampis, Wang, Hao-Jie, Fan, Wen-Jian, Yao, Pei-Sen, Lin, Yuan-Xiang, Goldbrunner, Roland, Zheng, Shu-Fa, Stavrinou, Pantelis, Kang, De-Zhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496804/
https://www.ncbi.nlm.nih.gov/pubmed/36138920
http://dx.doi.org/10.3390/brainsci12091183
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author Zhang, Yi-Bin
Zheng, Feng
Stavrinou, Lampis
Wang, Hao-Jie
Fan, Wen-Jian
Yao, Pei-Sen
Lin, Yuan-Xiang
Goldbrunner, Roland
Zheng, Shu-Fa
Stavrinou, Pantelis
Kang, De-Zhi
author_facet Zhang, Yi-Bin
Zheng, Feng
Stavrinou, Lampis
Wang, Hao-Jie
Fan, Wen-Jian
Yao, Pei-Sen
Lin, Yuan-Xiang
Goldbrunner, Roland
Zheng, Shu-Fa
Stavrinou, Pantelis
Kang, De-Zhi
author_sort Zhang, Yi-Bin
collection PubMed
description 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 μmol/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 μmol/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.
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spelling pubmed-94968042022-09-23 Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis Zhang, Yi-Bin Zheng, Feng Stavrinou, Lampis Wang, Hao-Jie Fan, Wen-Jian Yao, Pei-Sen Lin, Yuan-Xiang Goldbrunner, Roland Zheng, Shu-Fa Stavrinou, Pantelis Kang, De-Zhi Brain Sci Article 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 μmol/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 μmol/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. MDPI 2022-09-02 /pmc/articles/PMC9496804/ /pubmed/36138920 http://dx.doi.org/10.3390/brainsci12091183 Text en © 2022 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
Zhang, Yi-Bin
Zheng, Feng
Stavrinou, Lampis
Wang, Hao-Jie
Fan, Wen-Jian
Yao, Pei-Sen
Lin, Yuan-Xiang
Goldbrunner, Roland
Zheng, Shu-Fa
Stavrinou, Pantelis
Kang, De-Zhi
Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title_full Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title_fullStr Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title_full_unstemmed Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title_short Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis
title_sort admission serum iron as an independent risk factor for postoperative delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: a propensity-matched analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496804/
https://www.ncbi.nlm.nih.gov/pubmed/36138920
http://dx.doi.org/10.3390/brainsci12091183
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