Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Treatment Protocol
2.5. BNP Sample Collection and Management
2.6. Collection of Patient Data
2.7. Radiological Measurements
2.8. Statistical Analyses
3. Results
3.1. Cohort Patient Characteristics and Operative Technique
3.2. Symptoms and Neurological Deficits on Admission
3.3. Radiological Findings
3.4. Predictors of Elevated BNP Serum Levels
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Comorbidities, Neurological Condition, and Operative Technique | n | % |
---|---|---|
Comorbidities | ||
Atrial fibrillation (AF) | 11 | 11 |
Coronary heart disease (CHD) | 11 | 11 |
AF and CHD | 6 | 6 |
Antiplatelet/anticoagulant therapy | 47 | 47 |
Dementia | 11 | 11 |
Neurological condition | ||
GCS score = 15 | 53 | 53 |
GCS score < 15 | 47 | 47 |
Operative technique | ||
Burr hole trepanation | 79 | 79 |
Minicraniotomy | 19 | 19 |
Decompressive hemicraniectomy | 2 | 2 |
Parameters | n | % |
---|---|---|
Nonspecific symptoms | ||
Headache | 24 | 24 |
Dizziness | 12 | 12 |
Change in behavior | 10 | 10 |
Cognitive deterioration | 28 | 28 |
Gait and balance disturbances | 38 | 38 |
Seizure < 24 h | 9 | 9 |
Neurological Deficits | ||
Altered state of consciousness | 32 | 32 |
Aphasia | 31 | 31 |
anomic aphasia | 22 | 22 |
expressive aphasia | 7 | 7 |
receptive aphasia | 1 | 1 |
global aphasia | 1 | 1 |
Dysarthria | 9 | 9 |
Fine motor dysfunction | 16 | 16 |
Hemiparesis | 27 | 27 |
mild hemiparesis | 17 | 17 |
severe hemiparesis | 10 | 10 |
Parameters | BNP | ||||
---|---|---|---|---|---|
Mann–Whitney U Test | N | Medians (pg/mL) | U | z | p-Value |
Headache | 100 | Yes (35.1)/No (73.4) | 594.0 | −2.567 | 0.010 |
Dizziness | 100 | Yes (33.2)/No (56.7) | 0.088 | ||
Change in behavior | 100 | Yes (62.1)/No (51.2) | 0.421 | ||
Cognitive deterioration | 100 | Yes (54.1)/No (56.7) | 0.694 | ||
Gait and balance disturbance | 100 | Yes (44)/No (56.7) | 0.276 | ||
Seizure < 24 h | 100 | Yes (103.0)/No (53.1) | 0.309 | ||
Altered state of consciousness | 100 | Yes (73.1)/No (45.5) | 0.063 | ||
Aphasia | 100 | Yes (64.8)/No (53.1) | 0.554 | ||
Fine motor dysfunction | 100 | Yes (37.0)/No (56.7) | 0.290 | ||
Gait ataxia | 100 | Yes (59.8)/No (54.1) | 0.889 | ||
Dysarthria | 100 | Yes (95.0)/No (45.9) | 585.0 | 2.114 | 0.035 |
Hemiparesis | 100 | Yes (112.3)/No (42) | 1382.5 | 3082 | 0.002 |
Hemiparesis and/or dysarthria | 100 | Yes (93.1)/No (40.4) | 1553.5 | 3440 | 0.001 |
Head trauma < 24 h | 100 | Yes (135)/No (48) | 829.0 | 2.255 | 0.024 |
Presence of hyperdensity | 100 | Yes (53.1)/No (59.3) | 0.942 | ||
Presence of acute blood | 100 | Yes (55)/No (57.6) | 0.841 | ||
Hematoma volume (<140 mL) | 100 | Yes (73.4)/No (31.3) | 692.5 | −3.125 | 0.002 |
Spearman rank correlation | BNP | ||||
Parameters | N | Correlation coefficient | p-value | ||
Age | 100 | 0.413 | 0.0005 | ||
Hematoma volume | 100 | −0.274 | 0.006 | ||
Midline shift | 100 | −0.229 | 0.022 | ||
Volume of hyperdensity areas | 47 | −0.083 | 0.584 | ||
Mean HU of hyperdensity areas | 47 | 0.122 | 0.420 |
BNP | |||
---|---|---|---|
Predictors | B | 95% CI | p-Value |
Hemiparesis and/or dysarthria | 37.067 | 1.553–72.581 | 0.041 |
Hematoma volume < 140 mL | −38.764 | −77.062–−0.467 | 0.047 |
Age | 1.829 | 0.257–3.400 | 0.023 |
Head trauma < 24 h | 81.356 | 33.947–128.765 | 0.001 |
Headache | −16.177 | −59.798–27.445 | 0.463 |
Midline shift | 0.414 | −4.848–5.677 | 0.876 |
Dizziness | −2.349 | −54.087–49.390 | 0.928 |
Altered state of consciousness | 37.154 | −0.597–74.904 | 0.054 |
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Chihi, M.; Jabbarli, R.; Parlak, A.; Darkwah-Oppong, M.; Gembruch, O.; Wrede, K.H.; Sure, U.; Maslehaty, H. Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study. J. Clin. Med. 2021, 10, 1791. https://doi.org/10.3390/jcm10081791
Chihi M, Jabbarli R, Parlak A, Darkwah-Oppong M, Gembruch O, Wrede KH, Sure U, Maslehaty H. Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study. Journal of Clinical Medicine. 2021; 10(8):1791. https://doi.org/10.3390/jcm10081791
Chicago/Turabian StyleChihi, Mehdi, Ramazan Jabbarli, Ahmet Parlak, Marvin Darkwah-Oppong, Oliver Gembruch, Karsten Henning Wrede, Ulrich Sure, and Homajoun Maslehaty. 2021. "Predictors of Brain Natriuretic Peptide Serum Level Elevation in Patients with Symptomatic Chronic Subdural Hematoma: A Prospective Study" Journal of Clinical Medicine 10, no. 8: 1791. https://doi.org/10.3390/jcm10081791