• World Neurosurg · Apr 2015

    Presence of haptoglobin-2 allele is associated with worse functional outcomes after spontaneous intracerebral hemorrhage.

    • Santosh B Murthy, Andrew P Levy, Joshua Duckworth, Eric B Schneider, Hadar Shalom, Daniel F Hanley, Rafael J Tamargo, and Paul A Nyquist.
    • Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: smurth13@jhmi.edu.
    • World Neurosurg. 2015 Apr 1;83(4):583-7.

    ObjectiveTo determine if the haptoglobin (Hp) phenotype, which has been shown to be a predictor of clinical outcomes in cerebrovascular disorders, particularly subarachnoid hemorrhage, was predictive of functional outcomes after spontaneous intracerebral hemorrhage (ICH).MethodsPatients admitted with a diagnosis of ICH were prospectively included and divided into 3 groups based on their genetically determined Hp phenotype: 1-1, 2-1, and 2-2. Outcome measures included mortality and 30-day modified Rankin Scale scores. Demographics and outcomes were compared for each phenotype using multivariate linear regression analysis.ResultsThe study included 94 patients. The distribution of Hp phenotype was Hp 1-1, 12 (13%); Hp 2-1, 46 (49%); and Hp 2-2, 36 (38%). The 3 Hp subgroups did not differ in terms of demographic variables, comorbidities, or ICH characteristics. There was a nonsignificant trend toward increased mortality in Hp 2-1 and Hp 2-2 compared with Hp 1-1, with mortality of 8% in Hp 1-1, 17% in Hp 2-1, and 25% in Hp 2-2 (P = 0.408). In the regression model adjusted for confounders, Hp 2-1 (odds ratio = 0.05, 95% confidence interval = 0.01-0.47, P < 0.001) and Hp 2-2 phenotypes (odds ratio = 0.14, 95% confidence interval = 0.02-0.86, P = 0.045) had significantly lower odds of modified Rankin Scale scores 0-2 compared with Hp 1-1.ConclusionsAfter ICH, individuals with the Hp-2 allele (2-1 and 2-2) had worse functional outcomes than individuals with the Hp-1 allele (Hp 1-1). There was a nonsignificant association between Hp phenotype and mortality. Larger prospective studies with better surrogates of ICH outcomes are warranted.Copyright © 2015 Elsevier Inc. All rights reserved.

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