Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study
ObjectiveIntracerebral hemorrhage (ICH) is a common cerebrovascular disease characterized by high mortality and disability rates. Neuritin, significantly expressed in injured brain tissues, is implicated in the molecular mechanisms underlying acute brain injury. We aimed to explore the prognostic an...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1490023/full |
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| author | Yanwen Xu Hanyu Zhu Yuqi Su Zhizhi Chen Chuanliu Wang Ming Yang Feifei Jiang Yunping Li Yongming Xu |
| author_facet | Yanwen Xu Hanyu Zhu Yuqi Su Zhizhi Chen Chuanliu Wang Ming Yang Feifei Jiang Yunping Li Yongming Xu |
| author_sort | Yanwen Xu |
| collection | DOAJ |
| description | ObjectiveIntracerebral hemorrhage (ICH) is a common cerebrovascular disease characterized by high mortality and disability rates. Neuritin, significantly expressed in injured brain tissues, is implicated in the molecular mechanisms underlying acute brain injury. We aimed to explore the prognostic and predictive value of serum neuritin in ICH.MethodsIn this prospective cohort study, serum neuritin levels were measured at admission in 202 patients, on post-ICH days 1, 3, 5, 7, and 10 in 54 of these patients, and at the time of enrollment in 100 healthy controls. The Glasgow Coma Scale (GCS) and hematoma volume were used as severity indicators. A poor prognosis was defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days after ICH. END was defined as a decrease of ≥2 points in the GCS score within 24 h of admission. A multivariate logistic regression model was used to assess the independent relationships between serum neuritin levels, END, and poor prognosis.ResultsSerum neuritin levels were significantly increased at the time of patient admission, continued to rise on day 1, peaked on day 3, and then gradually diminished from day 5 until day 10. The levels remained substantially higher in patients compared to healthy controls throughout the 10-day period. The levels were independently related to GCS scores and hematoma volume. In subgroup analyses, the levels showed a linear relationship with the likelihood of experiencing END and poor prognosis at the 90-day mark after ICH. Additionally, the levels were independently associated with END, ordinal mRS scores, and poor prognosis. Under receiver operating characteristic (ROC) curve analysis, serum neuritin levels effectively predicted both END and poor prognosis. Two models incorporating GCS, hematoma volume, and serum neuritin levels were developed and represented using two nomograms separately to estimate END risks and poor prognosis. These models demonstrated clinical efficiency, stability, and validity in ROC, calibration, and decision curve analyses. Internal validation of the models was conducted using a randomly extracted subset of 101 patients. Furthermore, two specific weighted scoring systems were developed to optimize clinical prediction of poor prognosis and END after ICH.ConclusionElevated serum neuritin levels are strongly associated with disease severity, END, and 90-day poor neurological outcomes following ICH, establishing serum neuritin as a potential prognostic biomarker for ICH. |
| format | Article |
| id | doaj-art-73e09ad064ac4406a3fd1f88c0ebacad |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-73e09ad064ac4406a3fd1f88c0ebacad2025-01-07T05:24:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.14900231490023Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort studyYanwen Xu0Hanyu Zhu1Yuqi Su2Zhizhi Chen3Chuanliu Wang4Ming Yang5Feifei Jiang6Yunping Li7Yongming Xu8Department of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaOperation Room, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurosurgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaDepartment of Neurosurgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, ChinaObjectiveIntracerebral hemorrhage (ICH) is a common cerebrovascular disease characterized by high mortality and disability rates. Neuritin, significantly expressed in injured brain tissues, is implicated in the molecular mechanisms underlying acute brain injury. We aimed to explore the prognostic and predictive value of serum neuritin in ICH.MethodsIn this prospective cohort study, serum neuritin levels were measured at admission in 202 patients, on post-ICH days 1, 3, 5, 7, and 10 in 54 of these patients, and at the time of enrollment in 100 healthy controls. The Glasgow Coma Scale (GCS) and hematoma volume were used as severity indicators. A poor prognosis was defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days after ICH. END was defined as a decrease of ≥2 points in the GCS score within 24 h of admission. A multivariate logistic regression model was used to assess the independent relationships between serum neuritin levels, END, and poor prognosis.ResultsSerum neuritin levels were significantly increased at the time of patient admission, continued to rise on day 1, peaked on day 3, and then gradually diminished from day 5 until day 10. The levels remained substantially higher in patients compared to healthy controls throughout the 10-day period. The levels were independently related to GCS scores and hematoma volume. In subgroup analyses, the levels showed a linear relationship with the likelihood of experiencing END and poor prognosis at the 90-day mark after ICH. Additionally, the levels were independently associated with END, ordinal mRS scores, and poor prognosis. Under receiver operating characteristic (ROC) curve analysis, serum neuritin levels effectively predicted both END and poor prognosis. Two models incorporating GCS, hematoma volume, and serum neuritin levels were developed and represented using two nomograms separately to estimate END risks and poor prognosis. These models demonstrated clinical efficiency, stability, and validity in ROC, calibration, and decision curve analyses. Internal validation of the models was conducted using a randomly extracted subset of 101 patients. Furthermore, two specific weighted scoring systems were developed to optimize clinical prediction of poor prognosis and END after ICH.ConclusionElevated serum neuritin levels are strongly associated with disease severity, END, and 90-day poor neurological outcomes following ICH, establishing serum neuritin as a potential prognostic biomarker for ICH.https://www.frontiersin.org/articles/10.3389/fneur.2024.1490023/fullintracerebral hemorrhageneuritinearly neurological deteriorationprognosisseverityoutcome |
| spellingShingle | Yanwen Xu Hanyu Zhu Yuqi Su Zhizhi Chen Chuanliu Wang Ming Yang Feifei Jiang Yunping Li Yongming Xu Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study Frontiers in Neurology intracerebral hemorrhage neuritin early neurological deterioration prognosis severity outcome |
| title | Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study |
| title_full | Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study |
| title_fullStr | Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study |
| title_full_unstemmed | Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study |
| title_short | Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study |
| title_sort | serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage a prospective cohort study |
| topic | intracerebral hemorrhage neuritin early neurological deterioration prognosis severity outcome |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1490023/full |
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