Objective To investigate the predictive value of insulin like growth factor-1 (IGF-1) for inhospital
complications and short-term clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
Methods Patients who were diagnosed as aSAH and within 72 h after symptom onset were
selected. Upon admission and before aneurysm occlusion, plasma IGF-1 levels were measured.
Patients with aneurysmal subarachnoid hemorrhage characteristics, perioperative complications
and outcomes at discharge were analyzed. Logistic regression analyse was performed to identify
independent factors associated with the poor clinical outcomes (mRS>2) and complications in
hospital.
Results 118 consecutive aSAH patients and 122 health controls were evaluated. The IGF-1 levels
of aSAH patients were lower than that of health controls [69.00 (50.98, 93.85) ng/mL vs 81.05
(69.40, 102.78) ng/mL, P <0.0001]. A total of 37 patients with aSAH (31.4%) had poor outcomes at
discharge. More lower IGF-1 level (OR 0.971, 95%CI 0.946-0.996, P =0.0262), higher Hunt-Hess scales (III-V, OR 4.995, 95%CI 1.331-18.747, P =0.0007), delayed cerebral ischemia (OR 46.100,
95%CI 11.152-190.566, P <0.0001) and hydrocephalus (OR 7.768, 95%CI 1.088-55.463, P =0.0284)
in hospital were associated with poor clinical outcomes at discharge. The AUC of the IGF-1 level
was similar to that of the Hunt-Hess scales and delayed cerebral ischemia for the prediction of poor
outcome at discharge (P >0.05). A total of 71 aSAH patients (60.2%) had at least one complication.
Only the IGF-1 level on admission (OR 0.984, 95%CI 0.973-0.996, P =0.0082) can predict
complications in hospital.
Conclusions Lower IGF-1 levels at acute phase is the predictive factor for inhospital complications
and short-term poor outcome in patients with acute aSAH.
