• Erdem Güresir, Christoph Coch, Rolf Fimmers, Inja Ilic, Alexis Hadjiathanasiou, Tamara Kern, Simon Brandecker, Ági Güresir, Markus Velten, Hartmut Vatter, and Patrick Schuss.
• Department of Neurosurgery, University Hospital Bonn, Bonn, Germany. Electronic address: Erdem.Gueresir@ukbonn.de.
• J Crit Care. 2020 Dec 1; 60: 45-49.

IntroductionPurpose of the present study was to determine if routine biochemical markers of acute phase response are associated with unfavorable outcome in patients with good-grade aneurysmal SAH.Methods231 patients admitted with aneurysmal SAH and WFNS grade I - II were included in the present study. C-reactive protein (CRP) and procalcitonin (PCT) were measured within 24 h of admission. Outcome was assessed according to the modified Rankin Scale (mRS) after 6 months and stratified into favorable (mRS 0-2) vs. unfavorable (mRS 3-6).ResultsThe multivariate regression analysis revealed "elevated baseline CRP" (p = .001, OR 3.2, 95% CI 1.6-6.6), "elevated baseline PCT" (p = .004, OR 26.0, 95% CI 2.9-235.5), "male gender" (p = .02, OR 2.3, 95% CI 1.1-4.8), and "age ≥ 65 years" (p = .009, OR 2.7, 95% CI 1.3-5.8) as a model for the prediction of unfavorable outcome in patients with good-grade SAH.ConclusionAn initial inflammatory response could be a possible explanation for poor outcome in good-grade SAH patients. These findings might help to identify a subgroup of good grade SAH patients who are at greater risk for unfavorable outcome early during treatment course/at baseline, and who could benefit most from potential anti-inflammatory therapy.Copyright © 2020 Elsevier Inc. All rights reserved.

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