Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Issue 5 (8th March 2021)

• Record Type: Journal Article
• Authors: Leasure, Audrey C.; Kuohn, Lindsey R.; Vanent, Kevin N.; Bevers, Matthew B.; Kimberly, W. Taylor; Steiner, Thorsten; Mayer, Stephan A.; Matouk, Charles C.; Sansing, Lauren H.; Falcone, Guido J.; Sheth, Kevin N.
• Is Part Of: Stroke. Volume 52:Issue 5(2021)
• Page Start: 1733
• Page End: 1740
• Publication Date: 2021-03-08
• Subjects: brain injury -- cerebral hemorrhage -- cytokine -- edema -- odds ratio; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.120.032888
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Objectives: IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH). Methods: We performed an exploratory analysis of the recombinant activated FAST trial (Factor VII for Acute ICH). Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin Scale. In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema volumes. Results: Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (modified Rankin Scale, 4–6; per additional 1 ng/L, odds ratio, 1.30 [95% CI, 1.04–1.63]; P =0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex, and ICH location, and this association was modified by location (multivariable interaction, P =0.002), with a stronger association seen in lobar (β, 12.51 [95% CI, 6.47–18.55], P <0.001) versus nonlobar (β 5.32 [95% CI, 3.36–7.28], P <0.001) location. IL-6 was associated with perihematomal edema volume after adjustment for age, sex, ICH volume, and ICH location (β 1.22 [95% CI, 0.15–2.29], P =0.03). Treatment group was not associated with IL-6 levels or outcome. Conclusions: In the FAST trial population, higher admission IL-6 levels were associated with worse 90-day functional outcome and larger ICH and perihematomal edema volumes.