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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Bendel, Stepani Koivisto, Timo Ryynänen, Olli-Pekka Ruokonen, Esko Romppanen, Jarkko Kiviniemi, Vesa Uusaro, Ari |
| Abstract | Introduction Neuroendocrine deficiencies may affect recovery after aneurysmal subarachnoid hemorrhage (aSAH). Insulin like growth factor-I (IGF-I) regulates neuronal growth and apoptosis in ischemic stroke. Our study was designed to a) characterize the behavior of serum IGF-I and growth hormone (GH) in the acute and late phases after aSAH reflecting possible pituitary gland function and b) evaluate the association between IGF-I and morbidity assessed by Glasgow outcome scale (GOS) and health related quality of life (HRQoL) in patients with aSAH. Methods In this prospective cohort study, patients with aSAH (n = 30) were compared to patients who underwent elective aneurysm surgery (n = 16). Serum GH and IGF-I concentrations were measured daily for five (controls) or seven (aSAH) days and at three months. GOS and 15d HRQoL was measured at three months. A mixed models method was used for testing between the groups. For factors possibly affecting HRQoL in aSAH patients, we constructed a Bayesian predicting model using a P-course Bayesian classifier. Results The mean IGF-I concentrations for days one to five were 8.1 ± 3.5 nmol/l in patients with aSAH and 11.2 ± 3.1 in the control group (P = 0.01). No corresponding difference was found at three months. Serum GH concentrations were similar in both patient groups. Severity of the aSAH did not affect serum IGF-I concentrations. Patients with GOS ≤ 4 had lower IGF-I concentrations and lower HRQoL than patients with GOS 5 (P = 0.02 and 0.003 respectively). The 15d HRQoL was 0.81 ± 0.16 in patients with aSAH and 0.86 ± 0.09 in control patients (P = 0.24). In the Bayesian model, the use of statins prior to aSAH, hyponatremia, high maximal sequential organ specific score (SOFAmax), and low cumulative IGF-I concentrations on days one to seven were associated with poor HRQoL (accuracy 89%, sensitivity 86%, and specificity 93%). Conclusions IGF-I concentrations are low during acute aSAH, which may have an impact on morbidity. Trial registration ClinicalTrials.gov Identifier NCT00614887 |
| Related Links | https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc8988.pdf |
| Ending Page | 8 |
| Page Count | 8 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 13648535 |
| DOI | 10.1186/cc8988 |
| Journal | Critical Care |
| Issue Number | 2 |
| Volume Number | 14 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2010-04-28 |
| Access Restriction | Open |
| Subject Keyword | Intensive Critical Care Medicine Emergency Medicine Growth Hormone Growth Hormone Deficiency Glasgow Outcome Scale Serum Growth Hormone Growth Hormone Concentration |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine |
| Journal Impact Factor | 8.8/2023 |
| 5-Year Journal Impact Factor | 10.4/2023 |
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