Baseline IL-6 Levels Are Associated with Midline Shift and Functional Outcome in Spontaneous Intracerebral Hemorrhage: An Exploratoryanalysis of the Fast Trial
Year: 2019
Type: other
Abstract: Background: Interleukin-6 (IL-6), a proinflammatory cytokine, is an established biomarker in acute brain injury, but the clinical significance of IL-6 in spontaneous intracerebral hemorrhage (ICH) has not been studied. Objective: To determine whether IL-6 levels are associated with secondary injury and functional outcome after ICH.Methods: We performed an exploratory analysis of the recombinant activated factor VII for acute ICH (FAST) trial. Patients with baseline serum IL-6 levels were included. Linear and ordinal regression analyses were used to assess the associations between IL-6, 24-hour midline shift, and 90-day modified Rankin scale (mRS).Results: Of 842 enrolled patients, 557 (66%) had baseline IL-6 levels (mean age 64 [SD 13], female sex 203 [37%) and were included in the analysis. Excluded patients did not differ in ICH volume or outcome (p>0.2). ICH location was deep in 437 (78%) patients and lobar in 78 (22%). IL-6 levels were associated with ICH volume (uf062 0.26; 95% CI 0.17- 0.35; p<0.001) and were higher in patients with lobar versus deep ICH (7.4 ng/L [IQR 10.1] vs 4.0 ng/L [IQR 5.1]; p=0.004). IL-6 was associated with midline shift (uf062 0.40; 95%CI 0.10-0.69; p=0.009) after adjustment for ICH volume. In multivariable analysis, IL-6 was associated with worse mRS (OR 1.43; 95% CI 1.22-1.69; p=0.001) after adjustment for age, sex, ICH volume, GCS, intraventricular hemorrhage, hematoma expansion, location, and treatment. Treatment was not associated with IL-6 or outcome. Conclusions: In the FAST trial population, baseline IL-6 levels were associated with 24-hour midline shift and functional outcome. These results warrant further investigation of IL-6 as a biomarker for secondary injury and outcome after ICH.
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2970036406