The Role of SBDP Protein as a Potential Biomarker for Early-Onset Subarachnoid Hemorrhagic

<i>Background and Objectives:</i> Cerebral vasospasm is the most common complication of subarachnoid hemorrhage (SAH) that is related to high mortality and morbidity. Early biomarkers predicting those conditions are still limited. This study aims to analyze spectrin degradation products (SBDPs) as potential biomarkers for SAH patients, which can be used to monitor clinical outcomes. <i>Materials and Methods:</i> We conducted a prospective observational study in acute SAH within 72 h of onset. All patients underwent placement of continuous cerebrospinal drainage, and liquor was taken four times and analyzed using ELISA to measure SBDP150, SBDP145, and SBDP120 levels and analyzed using Friedman test and post hoc Wilcoxon analysis. The relationship between SBDP levels and vasospasm, as well as functional outcomes (using the Glasgow Outcome Scale-Extended, GOSE), was assessed. <i>Results:</i> We enrolled thirty-five patients: thirty patients with lumbar drainage (LD) and five with extra ventricular drainage (EVD). Friedman's analysis showed significant changes over time for SBDP120 (<i>p</i> = 0.0001) and SBDP145 (<i>p</i> = 0.0001), but not for SBDP150 (<i>p</i> = 0.218). Levels of SBDP120 on day 3 (<i>p</i> = 0.001), SBDP120 on day 5 (<i>p</i> = 0.022), and SBDP145 on day 3 (<i>p</i> = 0.005) in EVD group were higher than in the LD group. SBDP145 on day 5 was significantly higher in patients with vasospasm (<i>p</i> = 0.041 in all patients, <i>p</i> = 0.028 in LD patients), indicating its potential as an early biomarker for vasospasm. SBDP145 on day 7 (<i>p</i> = 0.014) is the strongest predictor of unfavorable GOSE at 90 days in all patients. In LD patients, SBDP145 on day 7 (<i>p</i> = 0.002), SBDP120 on day 7 (<i>p</i> = 0.009), and SBDP120 on day 10 (<i>p</i> = 0.043) were significantly associated with poor GOSE at 90 days. <i>Conclusions:</i> A higher level of SBDP145 on day 5 can predict vasospasm risk, while an elevated level of SBDP145 and SBDP120 on day 7 is a potential predictor of poor functional outcomes. SBDPs may serve as valuable biomarkers for SAH management.