Cancer Related Subarachnoid Hemorrhage: A Multicenter Retrospective Study Using Propensity Score Matching Analysis

Shijian Chen; Jian Zhang; Xianfu Lu; Gengyu Cen; Yiting Song; Xuhui Deng; Yiju Xie; Liuyu Liu; Qianqian Liu; Junling Huang; Jing Li; Hong Yang; Shengliang Shi; Liya Pan; Zhijian Liang

doi:10.3389/fncel.2022.813084

Cancer Related Subarachnoid Hemorrhage: A Multicenter Retrospective Study Using Propensity Score Matching Analysis

Front Cell Neurosci. 2022 Feb 7:16:813084. doi: 10.3389/fncel.2022.813084. eCollection 2022.

Authors

Shijian Chen¹, Jian Zhang¹, Xianfu Lu², Gengyu Cen¹, Yiting Song¹, Xuhui Deng¹, Yiju Xie¹, Liuyu Liu¹, Qianqian Liu², Junling Huang², Jing Li³, Hong Yang², Shengliang Shi⁴, Liya Pan², Zhijian Liang¹

Affiliations

¹ Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
² Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.
³ Department of Neurology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
⁴ Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China.

Abstract

Objective: To investigate the clinical features, risk factors and underlying pathogenesis of cancer related subarachnoid hemorrhage (SAH).

Methods: Clinical data of SAH in patients with active cancer from January 2010 to December 2020 at four centers were retrospectively reviewed. Patients with active cancer without SAH were matched to SAH patients with active cancer group. Logistic regression was applied to investigate the independent risk factors of SAH in patients with active cancer, after a 1:1 propensity score matching (PSM). A receiver operator characteristic curve was configured to calculate the optimal cut-off value of the joint predictive factor for cancer related SAH.

Results: A total of 82 SAH patients with active cancer and 309 patients with active cancer alone were included. Most SAH patients with cancer had poor outcomes, with 30-day mortality of 41.5%, and with 90-day mortality of 52.0%. The PSM yielded 75 pairs of study participants. Logistic regression revealed that a decrease in platelet and prolonged prothrombin time were the independent risk factors of cancer related SAH. In addition, receiver operator characteristic curve of the joint predictive factor showed the largest AUC of 0.8131, with cut-off value equaling to 11.719, with a sensitivity of 65.3% and specificity of 89.3%.

Conclusion: Patients with cancer related SAH often have poor outcomes. The decrease in platelet and prolonged prothrombin time are the independent risk factors of cancer related SAH, and the joint predictive factor with cutoff value equal to 11.719 should hence serve as a novel biomarker of cancer related SAH.

Keywords: cerebral hemorrhage; neoplasms; propensity score; stroke; subarachnoid hemorrhage.