Serum CAR and IL-6 independently correlate with brain injury severity and 28-day mortality after ICH, acting as easily accessible predictive biomarkers, with their combined model yielding an AUC of 0.810.
Serum CAR and IL-6 levels were markedly higher in 28-day non-survivors compared to survivors of intracerebral hemorrhage.
CAR independently predicted 28-day mortality in ICH patients after adjustment for age, hematoma volume, and admission GCS score.
IL-6 independently predicted 28-day mortality in ICH patients after adjustment for age, hematoma volume, and admission GCS score.
The combined CAR-IL-6 model demonstrated superior predictive performance for 28-day mortality compared to either biomarker alone.
Both CAR and IL-6 showed moderate negative correlations with GCS scores and weak positive correlations with ICH scores.
This research suggests that two blood biomarkers — the CRP-to-albumin ratio (CAR) and interleukin-6 (IL-6) — can help predict which patients with brain hemorrhage (intracerebral hemorrhage, or ICH) are more likely to die within 28 days of admission. The study followed 125 ICH patients in China, finding that patients who died within 28 days had significantly higher levels of both biomarkers at the time of hospital admission. Higher levels of these markers were also associated with more severe brain injury as measured by standard clinical tools. When used together in a combined model, CAR and IL-6 predicted 28-day mortality with an AUC (a measure of predictive accuracy) of 0.810, which is considered a reasonable level of discriminatory ability. This combined model performed significantly better than CAR alone. Each biomarker also independently predicted mortality even after accounting for other known risk factors such as age, hematoma volume, and initial level of consciousness. This research suggests that these two relatively simple and accessible blood tests, when measured at hospital admission, could help clinicians identify ICH patients at higher risk of short-term death, potentially enabling earlier and more aggressive management. However, the authors note that prospective studies are needed to confirm these findings before they can be routinely applied in clinical practice.
Tian Y, Liu J, Zhu D, Li C, Liu Y, Wang W. (2026). Systemic inflammatory biomarkers CAR and IL-6: correlation with neurological deficit and short-term prognosis of intracerebral hemorrhage.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1915042