title: Predictive value of serum caspase-cleaved cytokeratin-18 concentrations after acute intracerebral hemorrhage.
abstract: BACKGROUND
  Caspase-cleaved Cytokeratin-18 (CCCK-18) is released during apoptosis. Serum CCCK-18 concentrations are associated with prognosis of some critical illness. We investigated the potential relationships between serum CCCK-18 concentrations and disease severity and long-term clinical outcomes after intracerebral hemorrhage.
  
  
  METHODS
  Serum CCCK-18 concentrations were determined in a total of 102 patients and 102 controls. Multivariate models were used to predict high concentration of CCCK-18 and 6-month clinical outcomes. The predictive values were evaluated based on areas under receiver operating curve.
  
  
  RESULTS
  Compared with controls, serum CCCK-18 concentrations were increased in patients (245.8±108.3U/l vs. 23.6±18.1U/l, P<0.001). National Institute of Health Stroke Scale scores [odds ratio (OR), 1.164; 95% confidence interval (CI), 1.027-1.320; P=0.003] and hematoma volumes (OR, 1.079; 95% CI, 1.018-1.205; P=0.008) were independent predictors of high concentration of CCCK-18. CCCK-18 was identified as an independent predictor of 6-month mortality (OR, 1.019; 95% CI, 1.010-1.038; P=0.013) and 6-month unfavorable outcome (OR, 1.017; 95% CI, 1.008-1.029; P=0.032) and possessed high predictive values.
  
  
  CONCLUSIONS
  Increased serum CCCK-18 concentrations are associated with disease severity and clinical outcomes, suggesting that CCCK represent a novel prognostic predictive biomarker after intracerebral hemorrhage.
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Shui-Jun
authors.initials: SJ
authors.lastname: Gu
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China. Electronic address: sjghxml@163.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Hong-Fei
authors.initials: HF
authors.lastname: Xuan
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Xin-Zhi
authors.initials: XZ
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Dong
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Si
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Dian-Xiang
authors.initials: DX
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: Miao
mesh_terms: D000208:Acute Disease; D000368:Aged; D001774:Blood Chemical Analysis; D020169:Caspases / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D053538:Keratin-18 / Q000097:blood* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis
chemical_list: C488421:KRT18 protein, human; D053538:Keratin-18; D020169:Caspases
keywords: Biomarker; Caspase-cleaved cytokeratin-18; Clinical outcome; Intracerebral hemorrhage; Prognosis; Severity