title: The prognostic value of plasma soluble CD40 ligand levels following aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Increased circulating soluble CD40 ligand (sCD40L) levels have been reported to be associated with severity and mortality of severe traumatic brain injury. The current study tested the hypothesis that elevated plasma sCD40L levels are predictive of clinical outcomes of aneurysmal subarachnoid hemorrhage (aSAH).
  
  
  METHODS
  Plasma sCD40L concentrations of 120 aSAH patients and 120 healthy volunteers were measured using enzyme-linked immunosorbent assay. An unfavorable outcome was defined as Glasgow Outcome Scale score of 1-3.
  
  
  RESULTS
  Plasma sCD40L levels were significantly elevated in aSAH patients compared with healthy controls; plasma sCD40L levels were highly associated with clinical severity reflected by World Federation of Neurological Surgeons (WFNS) score and Fisher score; sCD40L emerged as an independent predictor of 6-month mortality and unfavorable outcome and 6-month overall survival; although a combined logistic-regression model did not demonstrate the additive benefit of sCD40L to WFNS score and Fisher score, sCD40L possessed similar predictive value to WFNS score and Fisher score based on receiver operating characteristic curves.
  
  
  CONCLUSIONS
  Higher plasma sCD40L levels on presentation are associated with clinical severity and have potential to be a good prognostic biomarker of aSAH.
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Xian-Dong
authors.initials: XD
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Hua-Jun
authors.initials: HJ
authors.lastname: Ba
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Mao-Hua
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jian-Hu
authors.initials: JH
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China. Electronic address: minleihu@163.com.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023201:CD40 Ligand / Q000097:blood*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D023201:CD40 Ligand
keywords: Intracranial aneurysmal; Prognosis; Severity; Soluble CD40 ligand; Subarachnoid hemorrhage