Serum Alkaline Phosphatase Level Is Associated With Functional Outcome After Aneurysmal Subarachnoid Hemorrhage

Background:Alkaline Phosphatase(ALP)has been implicated to be associated with poor outcome in ischemic stroke patients,yet its role in aneurysmal SAH(aSAH)patients is unknown.The current study aimed to investigate the associations of serum ALP level with vasospasm,DCI and outcome after aSAH.MethodsBetween May 2016 and December 2017,sixty-four consecutive aSAH patients were prospectively enrolled.Blood samples from patients and sixty-four healthy individuals were obtained.Baseline information,clinical and radiologic data were collected and serum ALP levels were measured.Patients were followed up for 6 monthsResultsSixty-four consecutive aSAH patients were prospectively enrolled,females were count to thirty-three,and males were 31.The oldest is 77,and the youngest is 35 while average is 56.9.The serum ALP levels in aSAH patients were significantly higher compared to controls(71 vs.60.5 U/L,p<0.001),yet did not differ significantly between patients with severe(WFNS 4-5)and mild clinical condition(WFNS 1-3)(73 vs.61 U/L,p=0.497).However,ALP was significantly higher in patients with severe radiologic status(modified Fisher 3-4)compared to those with mild radiologic status(76 vs.61 U/L,p=0.047).A significant correlation emerged between modified Fisher score and ALP level(r=0.252,p=0.045).The ALP level was significantly higher in patients with vasospasm and delayed cerebral ischemia(DCI)compared with those without(vasospasm,78 vs.62.5 U/L,p=0.0051;DCI,76 vs.65 U/L,p=0.0165).The ALP level was also higher in patients with unfavorable outcome(modified Rankin 3-6)compared with those without(96 vs.64 U/L,p<0.001).A ROC curve identified a baseline serum ALP level<80 U/L predicts 6-month unfavorable outcome(AUC,0.781;95%CI,0.643-0.919,p=0.0005).Finally,multivariate analysis found that WFNS score and ALP level were independently associated with unfavorable 6-month outcome(WFNS,OR=8.739,p=0.022;ALP,OR=1.24,p=0.006).Conclusion:High serum ALP level is associated with vasospasm,DCI and functional outcome after aSAH.Serum ALP might be a potential outcome predictor for aSAH patients.