Abstract Details

Title Prevalence and Impact of Systemic Inflammatory Response in Acute Intracerebral Hemorrhage

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-002

Objective 1) SIRS is prevalent during acute ICH and associated with ICH severity, 2) SIRS is associated with higher in-hospital mortality and poor functional outcome (modified Rankin score).

Background Emerging data suggest that systemic inflammation may exacerbate intracerebral hemorrhage (ICH). We aim to determine 1) systemic inflammatory response syndrome (SIRS) symptoms prevalence post-ICH, 2) association of SIRS with ICH severity and outcome.

Design/Methods Using ICD-9 code, we identified 306 consecutive adult (>18yrs) ICH patients presenting to UPMC Presbyterian Hospital between 2014-2015. We excluded patients presenting beyond 96 hrs from ICH onset, died within 3 days, or ICH secondary to outstanding conditions (e.g. trauma, malignancy), resulting in a final cohort of 212 subjects. We systematically extracted clinical data on SIRS symptoms, ICH onset, ICH Score, ICH location, patient epidemiology, and global functional outcome (mRS, Barthel Index). Proportions were compared using chi-square. Continuous variables were compared using student’s t or Wilcoxon rank sum.

Results Study cohort (mean age 71.2yrs; 43% female) has median ICH score 1(1-3). ICH locations were 42% lobar, 40% deep, 16% infratentorial ICH, and 2% intraventricular hemorrhage. In-hospital mortality was 17%. Acute phase ICH is defined as post-bleed (PB) days 1-7. During this time, HR (>50%) and respiratory rate (>63%) were the most common SIRS criteria met by this cohort. Up to 73% met >2 of 4 SIRS criteria between PB days 0-7. We defined SIRS burden (0-4) as the total SIRS criteria met at a given time. Higher SIRS burden is associated with higher ICH severity (p<0.0001), worse outcome at discharge (p<0.001), and higher mortality (p=0.0008). SIRS burden on PB 3-6 are independently associated with mortality after adjusting for age and ICH score (p=0.0047—p=0.028).

Conclusions SIRS symptoms are prevalent during acute ICH. SIRS burden is associated with ICH severity, worse outcome and mortality.

Authors/Disclosures
Lauren E. Kaplan PRESENTER	Ms. Kaplan has nothing to disclose.
	No disclosure on file
Fang Yu, Jr., MD (University of Pittsburgh)	No disclosure on file
Sherry Hsiang-Yi Chou, MD (Departmnt of Neurology, Northwestern Feinberg School of Medicine)	Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of NIH. An immediate family member of Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of Wells Fargo. Dr. Hsiang-Yi Chou has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Grace Therapeutics. The institution of Dr. Hsiang-Yi Chou has received research support from The Neurocritical Care Society. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Board of Director member with United Council of Neurologic Specialties that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair-elect, the Neurocritical Care Committee with American Heart Association, the Stroke Council that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair ellect, the Neurocritical Care Special Interest Group with American Neurologic Association that is relevant to AAN interests or activities.

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