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Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis.

Publication ,  Journal Article
Dicpinigaitis, AJ; Galea, VP; Sursal, T; Al-Shammari, H; Feldstein, E; Ali, S; Wong, S; Bowers, C; Becker, C; Pisapia, J; Muh, C; Hanft, S ...
Published in: J Neurosurg Sci
June 28, 2022

BACKGROUND: Delayed cerebral ischemia (DCI) represents a devastating complication of aneurysmal subarachnoid hemorrhage (aSAH) and is a significant predictor of morbidity and mortality. Recent studies have implicated inflammatory processes in the pathogenesis of DCI. METHODS: aSAH patient data were retrospectively obtained from the eICU Collaborative Research Database (eICU CRD). Multivariable logistic regression models and receiver operating characteristic (ROC) curve analyses were employed to assess the association between low serum albumin (< 3.4 g/dL) and clinical endpoints: DCI and in-hospital mortality. RESULTS: Among 276 aSAH patients included in the analysis, 35.5% (n=98) presented with low serum albumin levels and demonstrated a higher incidence of DCI (18.4% vs. 8.4%, OR=2.45, 95% CI 1.17, 5.10; p=0.017) and in-hospital mortality (27.6% vs. 16.3%, OR=1.95, 95% CI 1.08, 3.54; p=0.027) compared to patients with normal admission albumin values. In a multivariable model controlling for age and World Federation of Neurosurgical Societies grade, low serum albumin remained significantly associated with DCI (OR=2.52, 95% CI 1.18, 5.36; p=0.017), but not with in-hospital mortality. A combined model for prediction of DCI, encompassing known risk factors in addition to low serum albumin, achieved an area under the curve of 0.65 (sensitivity=0.55, specificity=0.75). CONCLUSIONS: Serum albumin, a routine and inexpensive laboratory measurement, can may potentially aid in the identification of patients with aSAH at risk for the development of DCI.

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Published In

J Neurosurg Sci

DOI

EISSN

1827-1855

Publication Date

June 28, 2022

Location

Italy

Related Subject Headings

  • Neurology & Neurosurgery
 

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Dicpinigaitis, A. J., Galea, V. P., Sursal, T., Al-Shammari, H., Feldstein, E., Ali, S., … Al-Mufti, F. (2022). Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis. J Neurosurg Sci. https://doi.org/10.23736/S0390-5616.22.05604-1
Dicpinigaitis, Alis J., Vincent P. Galea, Tolga Sursal, Hussein Al-Shammari, Eric Feldstein, Syed Ali, Serena Wong, et al. “Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis.J Neurosurg Sci, June 28, 2022. https://doi.org/10.23736/S0390-5616.22.05604-1.
Dicpinigaitis AJ, Galea VP, Sursal T, Al-Shammari H, Feldstein E, Ali S, et al. Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis. J Neurosurg Sci. 2022 Jun 28;
Dicpinigaitis, Alis J., et al. “Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis.J Neurosurg Sci, June 2022. Pubmed, doi:10.23736/S0390-5616.22.05604-1.
Dicpinigaitis AJ, Galea VP, Sursal T, Al-Shammari H, Feldstein E, Ali S, Wong S, Bowers C, Becker C, Pisapia J, Muh C, Hanft S, Tyagi R, Mayer SA, Gandhi CD, Al-Mufti F. Low serum albumin as a risk factor for delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: eICU collaborative research database analysis. J Neurosurg Sci. 2022 Jun 28;

Published In

J Neurosurg Sci

DOI

EISSN

1827-1855

Publication Date

June 28, 2022

Location

Italy

Related Subject Headings

  • Neurology & Neurosurgery