Relationship between serum level of C-reactive protein and prognoses in patients with aneurysmal subarachnoid hemorrhage

RUAN Dong; WANG Fang; GUO Li-rui; PENG Hong-mei; CHEN Qian-xue; LIU Bao-hui

doi:10.13798/j.issn.1009-153X.2017.09.006

Abstract：Objective To investigate the relationship between the serum level of C-reactive protein (CRP) and prognoses in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods The serum levels of CRP were determined before and 1, 3, 5 and 7 days after the operation and on discharge from hospital in 108 patients with aSAH from January, 2014 to August, 2015. Univariate and multivariate logistic regression analyses were used to explore the relationship of the serum levels of CRP with clinical outcomes. Receiver operating characteristic (ROC) curves were obtained to investigate the value of CRP to predicting the prognoses in the patients with aSAH. Results Of 108 patients, 68 patients had good outcome and 40 had poor outcome according to GOS score 3 months after operation. The serum levels of CRP were significantly higher in 40 patients with poor outcomes than those in 68 patients with good outcomes 1, 3, 5 and 7 days after the surgery as well as on discharge. The serum levels of CRP reached the top 1 day after the operation and then declined rapidly in the patients with poor outcomes. The multivariate analysis showed that the serum levels of CRP 1 and 3 days after the operation were significant related to poor outcomes in the patients with aSAH. The areas under the curve (AUV) for the serum levels of 1 and 3 days after the operation were 0.823 and 0.861, respectively. The serum level of CRP 3 days after the operation was positively related to the preoperative Hunt-Hess grades (r=0.42; P<0.05) and preoperative Fisher score (r=0.28; P<0.05) in the patients with aSAH. Conclusions It is suggested that the serum levels of CRP 1 and 3 days after the operation are of important value to predicting the prognoses in the patients with aSAH.