High serum levels of TAC and early mortality in patients with spontaneous intracerebral haemorrhage
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ORIGINAL ARTICLE
High serum levels of TAC and early mortality in patients with spontaneous intracerebral haemorrhage Leonardo Lorente 1 & María M. Martín 2 & Antonia Pérez-Cejas 3 & Agustín F. González-Rivero 3 & Rafael Sabatel 4 & Luis Ramos-Gómez 5 & Mónica Argueso 6 & Jordi Solé-Violán 7 & Juan J. Cáceres 8 & Alejandro Jiménez 9 & Victor García-Marín 10 Received: 14 March 2020 / Accepted: 28 August 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objective Oxidation contributes to secondary brain injury after spontaneous intracerebral haemorrhage (SIH). One study found lower levels of total antioxidant capacity (TAC) in the blood in patients with SIH than in healthy subjects. However, there are no data on blood TAC levels and survival in patients with SIH. Therefore, the objective of our study was to determine if an association exists between serum TAC levels and mortality in patients with SIH. Methods We included patients with severe supratentorial SIH. We considered severe when Glasgow Coma Scale (GCS) < 9. Patients from 6 Spanish hospitals were included in this observational and prospective study. Serum TAC levels at days 1, 4 and 8 of SIH were determined. Thirty-day mortality was our end-point study. Results Non-surviving patients compared with surviving patients showed higher serum TAC levels at day 1 (p < 0.001), 4 (p < 0.001) and 8 (p = 0.001). An area under the curve was found for the prediction of 30-day mortality by serum TAC levels of 0.92 (95% CI = 0.85–96%; p < 0.001). Multiple logistic regression analysis showed an association of serum TAC levels with 30-day mortality (odds ratio = 16.513; 95% CI = 2.548–107.015; p = 0.003) controlling for midline shift, glycemia, early evacuation of SIH, intracerebral haemorrhage (ICH) score, age and volume of SIH. Conclusions The new findings of this study are that serum TAC levels are higher in non-surviving than in surviving patients, and that they are associated with mortality and could be used to predict mortality. Keywords Spontaneous intracerebral haemorrhage . Total antioxidant capacity . Apoptosis . Patients . Mortality
Introduction Spontaneous intracerebral haemorrhage (SIH) is a major cause of resource consumption, disabilities and death [1]. Oxidative * Leonardo Lorente [email protected]
stress contributes to secondary brain injury in SIH [2]. Antioxidants are generated to prevent cell damage by reactive oxygen species (ROS) [2]. Determination of total antioxidant capacity (TAC), due to the synergy of different antioxidant
Mónica Argueso [email protected]
María M. Martín [email protected]
Jordi Solé-Violán [email protected]
Antonia Pérez-Cejas [email protected]
Juan J. Cáceres [email protected]
Agustín F. González-Rivero [email protected]
Alejandro Jiménez [email protected]
Rafael Sabatel [email protected] Luis Ramos-Gómez [email protected]
Victor García-Marín [email protected] Extended author information available on the last page of the article
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