TY - JOUR

T1 - Hypozincaemia is associated with severity of aneurysmal subarachnoid haemorrhage

T2 - a retrospective cohort study

AU - Arleth, Tobias

AU - Olsen, Markus Harboe

AU - Orre, Matias

AU - Rasmussen, Rune

AU - Bache, Søren

AU - Eskesen, Vagn

AU - Frikke-Schmidt, Ruth

AU - Møller, Kirsten

PY - 2020/6

Y1 - 2020/6

N2 - Background: Hypozincaemia may develop in critically ill patients, including those with acute brain injury in the early phase after hospital admission. The aim of this study was to investigate the prevalence of hypozincaemia after aneurysmal subarachnoid haemorrhage (aSAH) and its association with delayed cerebral ischemia and functional outcome. Methods: We retrospectively analysed a cohort of 384 patients with SAH admitted to the Neurointensive Care Unit at Rigshospitalet, Copenhagen, Denmark, in whom at least one measurement of plasma zinc concentration was done during the hospital stay. Hypozincaemia was defined as at least one measurement of plasma zinc below 10 μmol/L. Potential associations between hypozincaemia, demographic variables and functional outcome after aSAH were analysed in multivariable logistic regression models. Results: Hypozincaemia was observed in 67% (n = 257) of all patients and occurred within 7 days in more than 95% of all hypozincaemic patients. In a multivariable model, severe SAH (WFNS 3–5; OR 4.2, CI 2.21–8.32, p < 0.001) and Sequential Organ Failure Assessment (SOFA) score on the day of admission (OR 1.24, CI 1.11–1.40, p < 0.001) were independently associated with hypozincaemia. In another multivariable model, hypozincaemia was independently associated with an unfavourable outcome (defined as a modified Rankin Scale score from 3 to 6) (OR 1.97, CI 1.06–3.68, p = 0.032), as was age (OR 1.03, CI 1.01–1.05, p = 0.015), SOFA score on the day of admission (OR 1.14, CI 1.02–1.29, p = 0.02), a diagnosis of delayed cerebral ischaemia (OR 4.06, CI 2.29–7.31, p < 0.001) and a clinical state precluding assessment for delayed cerebral ischaemia (OR 15.13, CI 6.59–38.03, p < 0.001). Conclusion: Hypozincaemia occurs frequently after aSAH, is associated with a higher disease severity and independently contributes to an unfavourable outcome.

AB - Background: Hypozincaemia may develop in critically ill patients, including those with acute brain injury in the early phase after hospital admission. The aim of this study was to investigate the prevalence of hypozincaemia after aneurysmal subarachnoid haemorrhage (aSAH) and its association with delayed cerebral ischemia and functional outcome. Methods: We retrospectively analysed a cohort of 384 patients with SAH admitted to the Neurointensive Care Unit at Rigshospitalet, Copenhagen, Denmark, in whom at least one measurement of plasma zinc concentration was done during the hospital stay. Hypozincaemia was defined as at least one measurement of plasma zinc below 10 μmol/L. Potential associations between hypozincaemia, demographic variables and functional outcome after aSAH were analysed in multivariable logistic regression models. Results: Hypozincaemia was observed in 67% (n = 257) of all patients and occurred within 7 days in more than 95% of all hypozincaemic patients. In a multivariable model, severe SAH (WFNS 3–5; OR 4.2, CI 2.21–8.32, p < 0.001) and Sequential Organ Failure Assessment (SOFA) score on the day of admission (OR 1.24, CI 1.11–1.40, p < 0.001) were independently associated with hypozincaemia. In another multivariable model, hypozincaemia was independently associated with an unfavourable outcome (defined as a modified Rankin Scale score from 3 to 6) (OR 1.97, CI 1.06–3.68, p = 0.032), as was age (OR 1.03, CI 1.01–1.05, p = 0.015), SOFA score on the day of admission (OR 1.14, CI 1.02–1.29, p = 0.02), a diagnosis of delayed cerebral ischaemia (OR 4.06, CI 2.29–7.31, p < 0.001) and a clinical state precluding assessment for delayed cerebral ischaemia (OR 15.13, CI 6.59–38.03, p < 0.001). Conclusion: Hypozincaemia occurs frequently after aSAH, is associated with a higher disease severity and independently contributes to an unfavourable outcome.

KW - Brain injury

KW - Hypozincaemia

KW - Subarachnoid haemorrhage

KW - Zinc

U2 - 10.1007/s00701-020-04310-z

DO - 10.1007/s00701-020-04310-z

M3 - Journal article

C2 - 32246202

AN - SCOPUS:85082938354

VL - 162

SP - 1417

EP - 1424

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

ER -