title: Prognostic Value of Serum C-Reactive Protein in Spontaneous Intracerebral Hemorrhage: When Should We Take the Sample?
abstract: BACKGROUND
  Several studies showed a correlation between C-reactive protein and mortality in spontaneous intracerebral hemorrhage. However, the best time to measure C-reactive protein to assess prognosis is not yet clear. The purpose of this study was to determine if initial or H24-C-reactive protein is independently associated with 30-day mortality in intracerebral hemorrhage.
  
  
  METHODS
  This is a retrospective study done within years 2010-2015. All intracerebral hemorrhage cases with missing data or with autoimmune disease or neoplasm were excluded. Univariate and multivariate analyses were assessed for initial C-reactive protein, H24-C-reactive protein, and confounding factors.
  
  
  RESULTS
  Of 122 patients, 91 were selected. Only H24-C-reactive protein, hematoma volume, and infratentorial origin were independently associated with 30-day mortality in intracerebral hemorrhage. When adjusted with intracerebral hemorrhage score, H24-C-reactive protein with a cutoff value of 30 mg/L independently predicted 30-day mortality.
  
  
  CONCLUSIONS
  This study suggests that H24-C-reactive protein may be a more reliable marker than initial C-reactive protein in the prediction of mortality in intracerebral hemorrhage. A large multicentric study is necessary to confirm the interest of including H24-C-reactive protein to a modified intracerebral hemorrhage score for the prediction of 30-day mortality.
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia. Electronic address: youssefzied.elhechmi@rns.tn.
authors.forename: Youssef Zied
authors.initials: YZ
authors.lastname: Elhechmi
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia.
authors.forename: Malek
authors.initials: M
authors.lastname: Hassouna
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Chérif
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia.
authors.forename: Rym
authors.initials: R
authors.lastname: Ben Kaddour
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia.
authors.forename: Ines
authors.initials: I
authors.lastname: Sedghiani
authors.affiliation: Habib Thameur University Hospital, Faculty of Medicine of Tunis, University of Tunis ElManar, Tunis, Tunisia.
authors.forename: Zouheir
authors.initials: Z
authors.lastname: Jerbi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: C-reactive protein; Intracerebral hemorrhage; inflammation; mortality; prognosis