Explorative Values of Ubiquitin Carboxy-Terminal Hydrolase L1 in Spontaneous Subarachnoid Hemorrhage: Prediction of Clinical Outcomes and Delayed Cerebral Ischemia
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Spontaneous subarachnoid hemorrhage (sSAH) is a critical neurological condition with high mortality and significant long-term sequelae. Delayed cerebral ischemia (DCI) is a significant contributor to poor clinical outcomes. Despite advances in management, early predictors of clinical outcomes and DCI remain unclear. This study investigates whether serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), a neuronal injury biomarker, can predict functional outcomes, mortality, and DCI in patients with sSAH. METHODS: A prospective observational study was conducted from January 2022 to June 2024, enrolling adults (≥18 years) with sSAH confirmed by neuroimaging on admission. Blood samples were collected at 24 hours (T0), 72 hours (T1), and 7 days (T2) after sSAH onset. UCH-L1 levels were measured using an automated analyzer. Outcomes were functional status, assessed by the modified Rankin Scale at 14 days and 3 months, mortality, the occurrence of DCI, and determination of UCH-L1 cutoff values predictive of poor prognosis. RESULTS: A total of 102 patients with sSAH were included. UCH-L1 levels measured 24 hours after admission were independent predictors of poor outcomes ( P < .001) and DCI ( P = .026). The optimal UCH-L1 cutoff for predicting poor outcomes at 14 days and 3 months was 174.6 pg/mL (odds ratio 10.55, 95% CI 4.23-26.36 and odds ratio 7.79, 95% CI 3.11-19.52, respectively). CONCLUSION: Early serum UCH-L1 levels are significant predictors of clinical outcomes, mortality, and DCI in patients with sSAH, suggesting that UCH-L1 could be a promising biomarker for guiding early prophylactic and therapeutic interventions in the management of sSAH.
Source: Neurosurgery
Authors: Anna Maria Auricchio, Silvia Baroni, Michele Nichelatti, Miikka Korja, Francesco Calvanese, Hamid Reza Niknejad, Giulia Napoli, Andrea Bongiovanni, Giovanni Maria Ceccarelli, Renata Martinelli, Grazia Menna, Marco Obersnel, Luca Scarcia, Andrea Alexandre, Anselmo Caricato, Carmelo Lucio Sturiale, Alessio Albanese, Enrico Marchese, Marcello Covino, Francesco Doglietto, Albert van der Zwan, Andrea Urbani, Alessandro Olivi, Giuseppe Maria Della Pepa
Institutions: Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, University of Helsinki, Helsinki University Hospital, University Medical Center Utrecht, Sapienza University of Rome, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413284152