title: Interleukin-6 as a Prognostic Biomarker in Ruptured Intracranial Aneurysms.
abstract: BACKGROUND
  Interleukin-6 (IL-6), a proinflammatory cytokine, was found to surge in the cerebral spinal fluid after aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that the plasma level of IL-6 could be an independent biomarker in predicting clinical outcome of patients with ruptured intracranial aneurysm.
  
  
  METHODS
  We prospectively included 53 consecutive patients treated with platinum coil embolization of the ruptured intracranial aneurysm. Plasma IL-6 levels were measured in the blood samples at the orifices of the aneurysms and from peripheral veins. The outcome measure was the modified Rankin Scale one month after SAH. Multiple logistic regression analyses were used to evaluate the associations between the plasma IL-6 levels and the neurological outcome.
  
  
  RESULTS
  Significant risk factors for the poor outcome were old age, low Glasgow Coma Scale (GCS) on day 0, high Fisher grades, and high aneurysmal and venous IL-6 levels in univariate analyses. Aneurysmal IL-6 levels showed modest to moderate correlations with GCS on day 0, vasospasm grade and Fisher grade. A strong correlation was found between the aneurysmal and the corresponding venous IL-6 levels (ρ = 0.721; P<0.001). In the multiple logistic regression models, the poor 30-day mRS was significantly associated with high aneurysmal IL-6 level (OR, 17.97; 95% CI, 1.51-214.33; P = 0.022) and marginally associated with high venous IL-6 level (OR, 12.71; 95% CI, 0.90-180.35; P = 0.022) after adjusting for dichotomized age, GCS on day 0, and vasospasm and Fisher grades.
  
  
  CONCLUSIONS
  The plasma level of IL-6 is an independent prognostic biomarker that could be used to aid in the identification of patients at high-risk of poor neurological outcome after rupture of the intracranial aneurysm.
authors.affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Kao
authors.affiliation: Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan; Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Kwo-Whei
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chen-Ling
authors.initials: CL
authors.lastname: Kuo
authors.affiliation: Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Ching-Shan
authors.initials: CS
authors.lastname: Huang
authors.affiliation: Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Wan-Min
authors.initials: WM
authors.lastname: Tseng
authors.affiliation: Vascular and Genomic Center, Changhua Christian Hospital, Changhua, Taiwan; Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chin-San
authors.initials: CS
authors.lastname: Liu
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, School of Life Science, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ching-Po
authors.initials: CP
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D004621:Embolization, Therapeutic; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000134:cerebrospinal fluid; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000473:pathology
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6