• Christian Zweifel, Mira Katan, Philipp Schuetz, Andrea Ernst, Luigi Mariani, Beat Müller, and Mirjam Christ-Crain.
• Department of Neurosurgery, University Hospital of Basel, Switzerland.
• Biomarkers. 2011 Sep 1; 16 (6): 511-6.

BackgroundEndocrine alterations of the hypothalamic-pituitary-axis are one of the first measurable physiological changes in cerebral insults. During acute stress, human growth hormone (GH) is stimulated and has shown to have a prognostic value in various diseases. Within this pilot study, we evaluated the prognostic value of GH in patients with acute intracerebral hemorrhage (ICH).MethodsIn a prospective observational study in 40 consecutive patients with ICH, GH was measured on admission. The prognostic value of GH to predict 30-day mortality and 90-day functional outcome was assessed. Favorable functional outcome was defined as Barthel Index score >85 points and Modified Rankin Scale <3 points.ResultsGH levels were increased in patients who died within 30 days as compared to survivors (0.45 (IQR 0.20-1.51) vs. 1.51 (IQR 0.91-4.08) p = 0.03), and in patients with an unfavorable functional outcome as compared to patients with a favorable functional outcome after 90 days 0.28 (IQR 0.16-0.61) vs. 0.78 (IQR 0.31-1.99) p = 0.03). For mortality prediction, receiver-operating-characteristics revealed an area under the curve (AUC) on admission for GH of 0.78 (95% CI 0.60-0.96), which was in the range of the Glasgow Coma Score (GCS) (AUC 0.82 (95% CI 0.59-1.00) p = 0.80). For functional outcome prediction, GH had an AUC of 0.71 (95% CI 0.54-0.87), which was statistically not different from the GCS (AUC 0.81 (95% CI 0.68-0.94) p = 0.36).ConclusionsIn our small cohort of patients with acute ICH, elevated GH level were associated with increased mortality and worse outcome. If confirmed in a larger study, GH levels may be used as an additional prognostic factor in ICH patients. (ClincalTrials.gov number NCT00390962).

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