Biomarcadores séricos como predictores de mal pronóstico y mortalidad en pacientes con hemorragia subaracnoidea aneurismática en terapia intensiva

Abstract

Introduction

Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality and elevated risk of disability among survivors. Certain biomarkers function as predictors of poor prognosis and mortality in these patients. However, in most hospitals in Mexico these specific serum biomarkers are not available. The aim is to find accessible, economic and reproducible serum biomarkers.

Objective

To determine whether serum concentrations of leukocytes, platelets, glucose, phosphorus, potassium and lactate are related to poor prognosis and mortality in patients with aSAH.

Material and methods

Observational, descriptive, retrospective, analytical study, conducted from March 2022 to September 2023 in patients admitted to the Intensive Care Unit with aSAH. By means of a non-probabilistic convenience sampling, levels of leukocytes, platelets, glucose, phosphorus, potassium and lactate were obtained at admission and 24 h later. These parameters were correlated with poor prognosis and mortality.

Results

Of 84 patients registered, 18 died (21.4%), 14 presented cerebral infarction (16.7%), 23 neurological sequelae (27.4%). The rest (n = 29) remained without neurological sequelae (34.5%). Lactate levels > 1.55 mmol/L (AUC 0.698; p = 0.005) presented statistical significance at admission, as well as at 24 h with cutoff point > 1.25 mmol/L (AUC 0.743; p < 0.001), followed by leukocyte levels > 8.7 × 10*3 (AUC 0.674; p = 0.01) and platelets < 158 × 10*3 (AUC 0.657; p = 0.02). No biomarker presented significant correlation with prognosis.

Conclusions

In patients with aSAH, lactate values at admission and 24 h later are recommended to predict mortality.