title: Interleukin 6 in the Cerebrospinal Fluid as a Biomarker for Onset of Vasospasm and Ventriculitis After Severe Subarachnoid Hemorrhage.
abstract: OBJECTIVE
  The aim of the study was to investigate the diagnostic potential of interleukin 6 (IL-6) and other soluble biomarkers in serum and cerebrospinal fluid (CSF) for early diagnosis of cerebral vasospasm (cVSSAH) and external ventricular drain-associated ventriculitis (VCSAH) and to separate these conditions from aneurysmal subarachnoid hemorrhage (aSAH) without further complication (SAHw/o/c).
  
  
  METHODS
  The concentrations of serum biomarkers and markers in the CSF were collected in 63 consecutive patients with aSAH and external ventricular drainage. Arithmetical means and standard deviations, area under the curve (AUC), cutoff values (C-OFF), sensitivity (SE), and specificity (SP) were calculated for markers and their correlation with SAHw/o/c, cVSSAH, and VCSAH.
  
  
  RESULTS
  Clinical courses included 27 patients with cVSSAH, 17 with VCSAH, and 19 with SAHw/o/c. Mean ± standard deviationCSFIL-6 values were 7588 ± 4580 pg/mL at onset of VCSAHand 4102 ± 4970 pg/mL for cVSSAHand higher than 234 ± 239 pg/mL in SAHw/o/c(P < 0.001).CSFIL-6 showed excellent diagnostic potential for differing between VCSAHand SAHw/o/c(AUC, 1.00; C-OFF, 707; SE, 100%; SP, 100%), and a moderate diagnostic potential for differing VCSAHfrom cVSSAH(AUC, 0.757; C-OFF, 3100 pg/Ml; SE, 86.7%; SP, 70.6%). The concentration ofCSFIL-6 within the cVSSAHgroup was significantly increased compared with SAHw/o/c(AUC, 0.937; C-OFF, 530 pg/mL; SE, 87.5%; SP, 91.7%).
  
  
  CONCLUSIONS
  CSFIL-6 is increased after aSAH in patients with cVSSAHor VCSAH. Patients with aCSFIL-6 level higher than a C-OFF of 3100 pg/mL have an increased likelihood for VCSAH; patients withCSFIL-6 levels between 530 and 3100 pg/mL have an increased posttest probability for cVSSAH.
authors.affiliation: Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany. Electronic address: markus.lenski@med.uni-muenchen.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Lenski
authors.affiliation: Department of Anesthesiology, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Huge
authors.affiliation: Department of Anesthesiology, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Briegel
authors.affiliation: Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
authors.forename: Jörg-Christian
authors.initials: JC
authors.lastname: Tonn
authors.affiliation: Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schichor
authors.affiliation: Department of Neurosurgery, Hospital of the University of Munich-Campus Großhadern, LMU, Munich, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Thon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000134:cerebrospinal fluid; D015984:Causality; D058565:Cerebral Ventriculitis / Q000134:cerebrospinal fluid* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015850:Interleukin-6 / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000453:epidemiology*; D020301:Vasospasm, Intracranial / Q000134:cerebrospinal fluid* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015850:Interleukin-6
keywords: Aneurysm; Cerebral vasospasm; Cerebrospinal fluid; EVD-associated infection; Interleukin 6; Subarachnoid hemorrhage