Predictive value of cerebrospinal fluid heparin-binding protein and CD64 expression for postoperative central nervous system infection following intracerebral hemorrhage surgery.

Abstract

Objectives: To explore the association and predictive value of cerebrospinal fluid (CSF) heparin-binding protein (HBP) and cluster of differentiation 64 (CD64) levels with postoperative central nervous system (CNS) infection following hypertensive intracerebral hemorrhage surgery.

Methods: A retrospective analysis was conducted on 64 patients who developed postoperative CNS infections (infection group) and 70 patients without infections (non-infection group) after surgical treatment for hypertensive intracerebral hemorrhage at Shangyu People's Hospital of Shaoxing between February 2021 and February 2024. CSF HBP and CD64 levels were measured within 24-48 hours postoperatively. Univariate and multivariate logistic regression analyses were performed to identify risk factors for CNS infection. Receiver operating characteristic curve analysis was used to assess the predictive performance of the biomarkers.

Results: Patients in the infection group were significantly older than those in the non-infection group. CSF HBP and CD64 levels were significantly elevated in the infection group (all P<0.05). Additionally, peripheral blood levels of procalcitonin, lactate dehydrogenase, and C-reactive protein were higher, whereas albumin levels were lower in the infection group (all P<0.05). Multivariate analysis identified elevated CSF HBP and CD64 as independent risk factors for CNS infection. The area under the curve values for predicting CNS infections were 0.745 for CSF HBP alone, 0.709 for CSF CD64 alone, and 0.846 when both markers were combined.

Conclusions: Elevated CSF HBP and CD64 levels are closely associated with postoperative CNS infection following hypertensive intracerebral hemorrhage surgery. While each marker alone offers moderate predictive value, their combined use significantly enhances diagnostic accuracy.