Serum Procalcitonin Levels are Associated with Clinical Outcome in Intracerebral Hemorrhage.

Procalcitonin (PCT) has emerged as a new prognostic inflammatory marker in a variety of diseases. This study aimed to evaluate whether PCT is associated with increased risk of unfavorable outcome in intracerebral hemorrhage (ICH) patients. During January 2015-December 2016, we conducted a prospective cohort investigation involved 251 primary ICH patients who were admitted within 24 h after the onset of symptoms. We assessed serum PCT levels for all patients at admission. The functional outcome after 3 months was evaluated by modified Rankin Scale (mRS) and dichotomized as favorable (mRS 0-2) and unfavorable (mRS 3-6). The independent risk factors for unfavorable outcome and mortality after 3 months were examined by binary logistic regression. Of 251 ICH patients, the median PCT concentration was 0.053 µg/L (interquartile range 0.035-0.078 µg/L). Unfavorable outcome and mortality at 3 months were observed in 161 (64.1%) and 51 (20.3%) patients, respectively. After adjusting for potential confounders, patients with PCT levels in the top quartile (>0.078 ug/L), compared with the lowest quartile (<0.035 µg/L) were more likely to have a higher risk of poor functional outcome [odds ratio (OR) 7.341; 95% confidence interval (CI) 2.770-21.114; P = 0.001] and mortality (OR 7.483; 95% CI 1.871-24.458, P = 0.006). Furthermore, the area under the receiver operating characteristic curve of PCT showed 0.701 (95% CI 0.635-0.767) for worse functional prognosis, and 0.652 (95% CI 0.569-0.735) for mortality. This study demonstrated that elevated PCT levels at admission were independently associated with unfavorable clinical outcome in ICH patients.

Prognostic implication of earthquake-related loss and depressive symptoms in patients with heart failure following the 2008 earthquake in Sichuan.

BACKGROUND: Earthquake exposure is associated with adverse consequences for cardiovascular disease. However, in the context of depressive symptoms, the prognostic significance of heart failure (HF) related to earthquake-related loss has not been characterized before. HYPOTHESIS: To determine the prognostic impact of earthquake-related loss on event-free survival in patients with HF, with depression as a modifying factor. METHODS: Depressive symptoms were assessed by using the Zung Self-Rating Depression Scale in 404 HF patients who were followed up for 2 years after the earthquake to collect data on mortality and readmission. The Kaplan-Meier method was used to compare event-free survival between patients with and without earthquake-related loss. Cox proportional hazard regression modeling was used to examine the predicted outcomes for baseline variables. RESULTS: The proportion of patients with moderate/severe depressive symptoms among the HF patients with earthquake-related loss is much higher than their counterparts (27.038% vs 17.84%, P = 0.039). Heart failure patients without loss experienced longer event-free survival than patients with loss (P = 0.002), especially among patients without depressive symptoms (P = 0.003). Meanwhile, in a Cox proportional hazard regression model, the event-free survival was associated with earthquake-related loss, left ventricular ejection fraction, depressive symptoms, and chronic obstructive pulmonary disease or asthma. CONCLUSIONS: Heart failure patients without earthquake-related loss experienced longer event-free survival than did HF patients with severe loss. Earthquake-related loss was a predictor of poor outcomes in HF patients, particularly in patients without depression.