Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study
BackgroundA20 is an endogenous protective protein. We quantified serum A20 levels following acute intracerebral hemorrhage (ICH) and assessed their association with the severity of illness and clinical outcomes of patients.MethodsIn total, 243 patients with acute supratentorial ICH and 76 controls w...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1546934/full |
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| author | Chao Tang Chao Tang Wei Li Wei Li Suijun Zhu Suijun Zhu Min Zhang Min Zhang Gaofeng Xiong Yijuan Lin |
| author_facet | Chao Tang Chao Tang Wei Li Wei Li Suijun Zhu Suijun Zhu Min Zhang Min Zhang Gaofeng Xiong Yijuan Lin |
| author_sort | Chao Tang |
| collection | DOAJ |
| description | BackgroundA20 is an endogenous protective protein. We quantified serum A20 levels following acute intracerebral hemorrhage (ICH) and assessed their association with the severity of illness and clinical outcomes of patients.MethodsIn total, 243 patients with acute supratentorial ICH and 76 controls were included in this prospective cohort study. Serum A20 levels were measured at admission in all patients, at study entry in all controls, and on post-ICH days 1, 3, 5, 7, 10, and 14 in 76 patients. The National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volume were used to estimate the severity. Stroke-associated pneumonia (SAP), early neurological deterioration (END), and post-ICH 6-month poor prognosis (modified Rankin Scale scores: 3–6) were considered as the three outcome variables of interest.ResultsPatients, as opposed to controls, exhibited significantly heightened serum A20 levels from admission until 14 days following ICH, with a peak value at day 3. Serum A20 levels at all-time points after ICH, which were significantly correlated with NIHSS scores and hematoma volume, were significantly higher in patients with END, SAP, or poor prognosis than in those without the corresponding one. Serum A20 levels at admission possessed similar predictive ability of these clinical outcomes to those at other time points. Serum A20 levels at admission, along with initial NIHSS scores and hematoma volume, remained independent predictors of clinical outcomes among patients. As confirmed by numerous statistical approaches, their conjunctions comprised three prediction models: satisfactory stability, clinical validity, and discrimination efficiency.ConclusionSerum A20 levels were significantly increased following ICH and may accurately reflect hemorrhagic severity and effectively predict END, SAP, and poor neurological prognosis, suggesting that serum A20 may be a promising prognostic biomarker for ICH. |
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| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-e8b4488c5e3b43f6aaf387f5baeac3b72025-08-20T03:15:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-04-011610.3389/fneur.2025.15469341546934Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort studyChao Tang0Chao Tang1Wei Li2Wei Li3Suijun Zhu4Suijun Zhu5Min Zhang6Min Zhang7Gaofeng Xiong8Yijuan Lin9Department of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, ChinaDepartment of Neurosurgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, ChinaDepartment of Neurosurgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, ChinaDepartment of Neurosurgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, ChinaDepartment of Neurosurgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaEmergency Department, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaBackgroundA20 is an endogenous protective protein. We quantified serum A20 levels following acute intracerebral hemorrhage (ICH) and assessed their association with the severity of illness and clinical outcomes of patients.MethodsIn total, 243 patients with acute supratentorial ICH and 76 controls were included in this prospective cohort study. Serum A20 levels were measured at admission in all patients, at study entry in all controls, and on post-ICH days 1, 3, 5, 7, 10, and 14 in 76 patients. The National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volume were used to estimate the severity. Stroke-associated pneumonia (SAP), early neurological deterioration (END), and post-ICH 6-month poor prognosis (modified Rankin Scale scores: 3–6) were considered as the three outcome variables of interest.ResultsPatients, as opposed to controls, exhibited significantly heightened serum A20 levels from admission until 14 days following ICH, with a peak value at day 3. Serum A20 levels at all-time points after ICH, which were significantly correlated with NIHSS scores and hematoma volume, were significantly higher in patients with END, SAP, or poor prognosis than in those without the corresponding one. Serum A20 levels at admission possessed similar predictive ability of these clinical outcomes to those at other time points. Serum A20 levels at admission, along with initial NIHSS scores and hematoma volume, remained independent predictors of clinical outcomes among patients. As confirmed by numerous statistical approaches, their conjunctions comprised three prediction models: satisfactory stability, clinical validity, and discrimination efficiency.ConclusionSerum A20 levels were significantly increased following ICH and may accurately reflect hemorrhagic severity and effectively predict END, SAP, and poor neurological prognosis, suggesting that serum A20 may be a promising prognostic biomarker for ICH.https://www.frontiersin.org/articles/10.3389/fneur.2025.1546934/fullA20intracerebral hemorrhageoutcomeseveritybiomarkers |
| spellingShingle | Chao Tang Chao Tang Wei Li Wei Li Suijun Zhu Suijun Zhu Min Zhang Min Zhang Gaofeng Xiong Yijuan Lin Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study Frontiers in Neurology A20 intracerebral hemorrhage outcome severity biomarkers |
| title | Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study |
| title_full | Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study |
| title_fullStr | Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study |
| title_full_unstemmed | Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study |
| title_short | Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study |
| title_sort | association of serum a20 levels with stroke associated pneumonia early neurological deterioration and poor neurological prognosis following acute supratentorial intracerebral hemorrhage a prospective cohort study |
| topic | A20 intracerebral hemorrhage outcome severity biomarkers |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1546934/full |
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