Purpose: Nosocomial infections are some of the main causes of worsening outcomes and death in aneurysmal subarachnoid hemorrhage patients. We hypothesize that combination of clinical parameters and blood biomarkers could increase the capacity of individual markers to dichotomize the patients at risk of infections. Methods: The present study included 104 patients (69 infected/35 non-infected) from two independent European cohorts. Accuracy of biomarkers (serum amyloid A, C-reactive protein,

more »

... erin and WBC) and clinical parameters (WFNS, GCS and age) were evaluated at hospital admission using receiver operating characteristic curves. The most accurate panel combination was obtained using Panelomix. Results: At hospital admission, the most sensitive parameters for the stratification of patients at risk of developing an infection were SAA and the WFNS. To reach a SP of 100% (95% CI, 100-100), SE values of 26.9% (95% CI, 15.9-38.1) and 31.9% (95% CI, 21.7-43.5) were obtained respectively. Moreover, the combination of SAA, WBC, WFNS, and age significantly improved the SE to 64.3% (95% CI, 50-78.6). Conclusions: At hospital admission the panel SAA, WBC, WFNS, and age appear as a promising tool for predicting in-hospital infections, which could lead to a better management of patients and in their associated outcomes. Azurmendi L (2017) Infection prediction for aneurysmal subarachnoid hemorrhage patients at hospital admission: combined panel of serum amyloid A and clinical parameters