A two-center observational analytic study of serum peroxiredoxin 6 as a potential biomarker in relation to severity and poor prognosis after aneurysmal subarachnoid hemorrhage

Objective This study aims to investigate association of serum peroxiredoxin 6 (Prx6) levels with severity and clinical prognosis of aneurysmal subarachnoid hemorrhage (aSAH). Methods In this two-center observational analytic study, serum Prx6 levels were measured in 100 healthy controls and 220 aSAH patients. Outcome measures included delayed cerebral ischemia (DCI) and poor prognosis (defined as Glasgow Outcome Scale of 1–3) at three months following aSAH. The prognostic association was validated through multivariate analysis. Results Compared with the control group, serum Prx6 levels were significantly elevated in aSAH patients. Patients’ Prx6 levels were independently associated with modified Fisher scores, Hunt-Hess scores, and Glasgow Outcome Scale scores, as well as independently predicted DCI and poor prognosis. Under the receiver operating characteristic (ROC) curve, serum Prx6 levels effectively predicted DCI and poor prognosis. The linear relationship between Prx6 levels and their risks were validated. DCI and poor prognosis models combining serum Prx6 levels demonstrated high predictive capability by calculating area under ROC curve and model improvement rate. Both models were graphically represented by nomogram and showed clinical stability and value by using calibration curves and decision curves. Conclusions Elevated serum Prx6 levels after aSAH are closely associated with increased severity, DCI and poor prognosis, suggesting that serum Prx6 may be a promising biomarker for assessing the severity of aSAH and predicting clinical outcomes.