Randomized trial reveals blood biomarkers predict mortality in intracerebral hemorrhage, indicating critical assessment for patient outcomes.
Background Stroke is a multifactorial disease. Intracerebral hemorrhage (ICH) is associated with high mortality, morbidity, and recurrence rates worldwide. Studies have reported the accuracy of several blood biomarkers in predicting clinical outcomes; however, their independent contributions to prediction remain to be established. Aim To determine the predictive accuracy of clinical outcomes in patients with ICH in North Indians using blood-based biomarkers. Methods A total of 250 ICH cases were enrolled within 72 hours of onset. Baseline clinical and CT scan measurements were recorded. Serum C-reactive protein (CRP), E-selectin (SELE), and P-selectin (SELP), matrix metalloproteinase-9 (MMP9), and plasma Homocysteine (HCY) levels were measured through ELISA. A telephone follow-up was done at six months using the Modified Rankin Scale (mRS). Results The study cohort's mean age was 54.9 (SD±12.8) years, with 64.8% male patients. A total of 117 (46.8%) deaths were observed over a six-month follow-up. Patients were categorized into two groups; alive (mRS: 0-5) and dead (mRS: 6). ICH cases with mortality had significantly higher serum CRP(p=0.03), MMP-9(p=0.005), SELE (p=0.005), and plasma HCY (0.04), but we did not observe a significant difference in serum SELP (p=0.17) at six months with mortality. Area under the receiver operating characteristics curve (AUROC) for 180-day mortality was 0.57 (HCY), 0.58 (CRP), 0.75 (MMP9), 0.79 (SELE), and 0.76 (SELP). Conclusion Our findings suggest that serum CRP, MMP-9, SELE, and plasma HCY were significant predictors of mortality at 6 months in patients with ICH in the north Indian population. Conflict of interest Authors have nothing to disclose
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