NYMC Faculty Publications

Low Serum Albumin as a Risk Factor for Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: Eicu Collaborative Research Database Analysis

Alis J. Dicpinigaitis, School of Medicine, New York Medical College, Valhalla, NY, USA.
Vincent P. Galea, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Tolga Sursal, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Hussein Al-Shammari, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA.Follow
Eric Feldstein, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Syed Ali, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA.Follow
Serena Wong, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Christian Bowers, Department of Neurosurgery, University of New Mexico, Albuquerque, NM, USA.
Christian Becker, Department of Medicine, Westchester Medical Center, Valhalla, NY, USA.
Jared Pisapia, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.Follow
Carrie Muh, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.Follow
Simon Hanft, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.Follow
Rachana Tyagi, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Stephan A. Mayer, School of Medicine, New York Medical College, Valhalla, NY, USA.Follow
Chirag D. Gandhi, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.Follow
Fawaz Al-Mufti, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA - fawaz.al-mufti@wmchealth.org.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.23736/S0390-5616.22.05604-1

Journal Title

Journal of Neurosurgical Sciences

First Page

287

Last Page

293

Document Type

Article

Publication Date

6-1-2024

Department

Neurosurgery

Second Department

Neurology

Abstract

BACKGROUND: Delayed cerebral ischemia (DCI) represents a devastating complication of aneurysmal subarachnoid hemorrhage (aSAH) and is a significant predictor of morbidity and mortality. Recent studies have implicated inflammatory processes in the pathogenesis of DCI. METHODS: aSAH patient data were retrospectively obtained from the eICU Collaborative Research Database (eICU CRD). Multivariable logistic regression models and receiver operating characteristic (ROC) curve analyses were employed to assess the association between low serum albumin (<3.4 g/dL) and clinical endpoints: DCI and in-hospital mortality. RESULTS: Among 276 aSAH patients included in the analysis, 35.5% (N.=98) presented with low serum albumin levels and demonstrated a higher incidence of DCI (18.4% vs. 8.4%, OR=2.45, 95% CI=1.17, 5.10; P=0.017) and in-hospital mortality (27.6% vs. 16.3%, OR=1.95, 95% CI=1.08, 3.54; P=0.027) compared to patients with normal admission albumin values. In a multivariable model controlling for age and World Federation of Neurosurgical Societies grade, low serum albumin remained significantly associated with DCI (OR=2.52, 95% CI=1.18, 5.36; P=0.017), but not with in-hospital mortality. A combined model for prediction of DCI, encompassing known risk factors in addition to low serum albumin, achieved an area under the curve of 0.65 (sensitivity = 0.55, specificity = 0.75). CONCLUSIONS: Serum albumin, a routine and inexpensive laboratory measurement, may potentially aid in the identification of patients with aSAH at risk for the development of DCI.

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