Is the ratio of lactated to pyrostaphylic acid in cerebral tissue a prognostic index for the outcome of patients with intracerebral hemorrhage?

Introduction

The objective was to correlate the ratio of lactated to pyrostaphylic acid (L/P) with the outcome of patients with intracerebral hemorrhage, according to the Glasgow Outcome Scale (GOS).

Methods

ICU patients with spontaneous intracerebral hemorrhage, diagnosed with a brain CT, were enrolled in the study. The inclusion criterion was a GCS on admission <8. An intracranial microdialysis catheter was inserted in cerebral tissue and extracellular brain fluid sample was collected every 2 hours for analysis. A CMA 600 Microdialysis Analyzer was used for measurements. Patients were divided into two groups according to their GOS score 6 months later, group A (GOS 4–5, good outcome) and group B (GOS 1–3, poor outcome). The variable of L/P was dichotomized and a value that was statistically significant correlated to the outcome was investigated. Comparison of the mean value of L/P between the two groups was carried out at a significance level of 95%.

Results

There were 29 patients enrolled in the study, with a mean age of 62 years (± 9.86). Six months later there were six patients in group A (mean L/P value: 34.13 ± 2.64) and 23 patients in group B (mean L/P value: 41.21 ± 16.39). There was a borderline correlation between the L/P value and the outcome between the two groups. Group A with a good outcome had a lower mean L/P ratio value (P = 0.059). All patients with a good outcome had an L/P value lower than 37, whereas all patients with an L/P value greater than 37 had a poor outcome, as is shown in Table 1.

Table 1 Correlation between L/P ratio and GOS scale

Conclusion

According to our results, the lactated to pyrostaphylic acid ratio is correlated to the outcome of patients with intracerebral hemorrhage, 6 months after admission to the ICU.