Evidence map›Paper›PMID 35750931›Full record

Observational studyNeurocritical care2022

C-Terminal Proarginine Vasopressin is Associated with Disease Outcome and Mortality, but not with Delayed Cerebral Ischemia in Critically Ill Patients with an Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.

Jos A H van Oers, Dharmanand Ramnarain, Annemarie Oldenbeuving, Piet Vos, Gerwin Roks, Yvette Kluiters, Albertus Beishuizen, Dylan W de Lange, Harm-Jan de Grooth, Armand R J Girbes

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Neurocritical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Jos A H van OersDepartment of Intensive Care Medicine, Elisabeth Tweesteden Ziekenhuis, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands. jah.vanoers@etz.nl.ORCID 0000-0001-8666-9810
Dharmanand RamnarainDepartment of Intensive Care Medicine, Elisabeth Tweesteden Ziekenhuis, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
Annemarie OldenbeuvingDepartment of Intensive Care Medicine, Elisabeth Tweesteden Ziekenhuis, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
Piet VosDepartment of Intensive Care Medicine, Elisabeth Tweesteden Ziekenhuis, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
Gerwin RoksDepartment of Neurology, Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands.
Yvette KluitersDepartment of Clinical Chemistry, Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands.
Albertus BeishuizenDepartment of Intensive Care Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
Dylan W de LangeDepartment of Intensive Care Medicine, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands.
Harm-Jan de GroothDepartment of Intensive Care Medicine, Amsterdam University Medical Centre, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Armand R J GirbesDepartment of Intensive Care Medicine, Amsterdam University Medical Centre, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Elisabeth-TweeSteden Ziekenhuis · NLVrije Universiteit Amsterdam · NLMedisch Spectrum Twente · NLUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAneurysmal subarachnoid hemorrhage (aSAH) is an important indication for intensive care unit admission and may lead to significant morbidity and mortality. We assessed the ability of C-terminal proarginine vasopressin (CT-proAVP) to predict disease outcome, mortality, and delayed cerebral ischemia (DCI) in critically ill patients with aSAH compared with the World Federation of Neurological Surgeons (WFNS) score and Acute Physiological and Chronic Health Evaluation IV (APACHE IV) model.

methodsC-terminal proarginine vasopressin was collected on admission in this single-center, prospective, observational cohort study. The primary aim was to investigate the relationship between CT-proAVP and poor functional outcome at 1 year (Glasgow Outcome Scale score 1-3) in a multivariable logistic regression model adjusted for WFNS and APACHE IV scores. Secondary aims were mortality and DCI. The multivariable logistic regression model for DCI was also adjusted for the modified Fisher scale.

resultsIn 100 patients, the median CT-proAVP level was 24.9 pmol/L (interquartile range 11.5-53.8); 45 patients had a poor 1-year functional outcome, 19 patients died within 30 days, 25 patients died within 1 year, and DCI occurred in 28 patients. Receiver operating characteristics curves revealed high accuracy for CT-proAVP to identify patients with poor 1-year functional outcome (area under the curve [AUC] 0.84, 95% confidence interval [CI] 0.77-0.92, p < 0.001), 30-day mortality (AUC 0.84, 95% CI 0.76-0.93, p < 0.001), and 1-year mortality (AUC 0.79, 95% CI 0.69-0.89, p < 0.001). CT-proAVP had a low AUC for identifying patients with DCI (AUC 0.67, 95% CI 0.55-0.79, p 0.008). CT-proAVP ≥ 24.9 pmo/L proved to be a significant predictor for poor 1-year functional outcome (odds ratio [OR] 8.04, 95% CI 2.97-21.75, p < 0.001), and CT-proAVP ≥ 29.1 pmol/L and ≥ 27.7 pmol/L were significant predictors for 30-day and 1-year mortality (OR 9.31, 95% CI 1.55-56.07, p 0.015 and OR 5.15, 95% CI 1.48-17.93, p 0.010) in multivariable models with WFNS and APACHE IV scores. CT-proAVP ≥ 29.5 pmol/L was not a significant predictor for DCI in a multivariable model adjusted for the modified Fisher scale (p = 0.061).

conclusionsC-terminal proarginine vasopressin was able to predict poor functional outcome and mortality in critically ill patients with aSAH. Its prognostic ability to predict DCI was low.

trial registrationNederlands Trial Register: NTR4118.

Indexed as

Brain IschemiaSubarachnoid HemorrhageCerebral InfarctionCohort StudiesCritical IllnessHumansProspective StudiesVasopressinsVasopressinsaSAHCT-proAVPPrognosis

Identifiers

PMID35750931
PMCPMC9672019
OpenAlexW4283464202

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.