Subclinical change of liver function could also provide a clue on prognosis for patients with spontaneous intracerebral hemorrhage

Neurol Sci. 2016 Oct;37(10):1693-700. doi: 10.1007/s10072-016-2656-0. Epub 2016 Jul 8.

Abstract

Whether subclinical change of liver function is associated with outcome of spontaneous intracerebral hemorrhage remains to be an open question. A total of 639 patients of spontaneous intracerebral hemorrhage within 7 days from stroke onset were finally enrolled. Liver function indicators, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin (BIL), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), albumin (ALB), and international normalized ratio (INR), were collected and collapsed into quartiles. The main outcomes were 30-day death, 90-day death, and 90-day poor outcome (modified Rankin Scale score of 3-6). Two adjusted model, Model 1 and Model 2 (Model 1 plus GCS score), were established to identify independent association between liver function indicators and ICH outcomes. The mortality rate was 19.9 % (127/639) at 30 days and 21.3 % (136/639) at 90 days. Rate of 90-day poor outcome was 51.5 % (329/639). Among liver function indicators, AST and ALP were associated with all the three outcomes, which did not alter significantly when adjusted by Model 1. After adjusted by Model 2, ALP was still associated with outcomes. Association between AST and outcomes was, however, weakened significantly by GCS score. In conclusions, among liver function indicators, AST and ALP were associated with outcomes after spontaneous intracerebral hemorrhage.

Keywords: Intracerebral hemorrhage; Liver function; Outcome; Risk factor.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / metabolism
  • Albumins / metabolism
  • Alkaline Phosphatase / metabolism
  • Aspartate Aminotransferases / metabolism
  • Bilirubin / metabolism
  • Female
  • Humans
  • Intracranial Hypotension / diagnosis*
  • Intracranial Hypotension / etiology
  • Intracranial Hypotension / mortality
  • Liver / metabolism
  • Liver / physiopathology*
  • Liver Function Tests
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Stroke
  • Time Factors
  • gamma-Glutamyltransferase / metabolism

Substances

  • Albumins
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Alkaline Phosphatase
  • Bilirubin