Microalbuminuria is a prognostic predictor in aneurysmal subarachnoid hemorrhage.
OBJECTIVE
To determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH).


METHODS
Prospective and observational clinical study.


METHODS
Multidisciplinary intensive care unit.


METHODS
Fifty-one consecutive patients who underwent aneurysm clipping or endovascular surgery after SAH; 8 patients who underwent surgical clipping for unruptured intracerebral aneurysm served as control.


METHODS
None.


RESULTS
General clinical and neurological data were recorded on admission. Urine was collected preoperatively and daily for up to 7 days postoperatively for measuring the urinary microalbumin/creatinine ratio. The Glasgow Coma Scale (GCS) score was also determined on admission and daily for up to 7 days after operation. Neurological outcome was assessed using the Glasgow Outcome Scale (GOS) at 3 months after stroke. The prevalence rates of microalbuminuria were 74.5% in SAH and 37.5% in the control. Among the 51 patients, 25 had unfavorable neurological outcome (GOS 1-3). The areas under the receiver operator characteristic curves showed that the highest urinary microalbumin/creatinine ratio and the lowest GCS score during the first 8 days were the significant predictors of unfavorable neurological outcome. The threshold value, sensitivity, specificity, and likelihood ratio for the highest urinary microalbumin/creatinine ratio were 200 mg/g, 60% [95% confidence interval (CI) 41-79], 96% (95% CI 88-100), and 15.6 (95% CI 9.1-26.7), respectively.


CONCLUSIONS
This study confirms a high prevalence of microalbuminuria in the SAH patients, and it suggests that the highest urinary microalbumin/creatinine ratio > 200 mg/g during the first 8 days is a significant predictor of unfavorable neurological outcome.
Terao
Yoshiaki
Y
Nagasaki Rosai Hospital, Department of Anesthesia, 2-12-5 Setogoe, Sasebo 857-0134, Japan. yoterao@na-robyo.jp
Takada
Masafumi
M
Tanabe
Takahiro
T
Ando
Yuko
Y
Fukusaki
Makoto
M
Sumikawa
Koji
K
D000368:Aged; D000419:Albuminuria / Q000652:urine*; D015415:Biomarkers; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*
D015415:Biomarkers