Evaluation of C-Reactive Protein Levels as Prognostic Indicators in Subarachnoid Hemorrhage Patients

Aim: Subarachnoid hemorrhage (SAH) is a life-threatening condition often leading to severe complications such as cerebral vasospasm, delayed cerebral ischemia, and high mortality rates. Identifying reliable biomarkers to predict clinical outcomes can aid in improving patient management and tailoring therapeutic interventions. This study aims to evaluate the prognostic value of C-reactive protein (CRP) levels in predicting clinical outcomes, including functional recovery, incidence of vasospasm, and mortality, in SAH patients within the first 14 days post-hemorrhage Material and Methods: A retrospective analysis of 263 patients diagnosed with spontaneous SAH between 2018 and 2024 was conducted. Patients were classified into aneurysmal SAH (ASAH) and non-aneurysmal SAH (NASAH) groups based on digital subtraction angiography findings. CRP levels were measured daily for 14 days, and clinical outcomes were assessed using the Modified Rankin Scale and Kaplan- Meier survival analysis. Results: Patients with ASAH exhibited significantly higher CRP levels (median: 516 mg/L) and longer durations of CRP >100 mg/L compared to NASAH patients. Higher CRP levels correlated positively with worse mRS scores and increased vasospasm incidence. Survival analysis revealed that ASAH patients with CRP >200 mg/L had significantly reduced survival rates (45%) compared to those with lower CRP levels (72%, p < 0.001). Conclusion: Elevated CRP levels are strongly associated with poor functional outcomes, increased vasospasm, and higher mortality in SAH patients, particularly in those with aneurysmal rupture. Incorporating CRP monitoring into routine clinical practice may enhance prognostication and guide targeted therapies