Immune-related Circulating Biomarkers in Intracerebral Hemorrhage: Implications for Nursing Management and Prognostic Assessment

Abstract

Intracerebral hemorrhage (ICH) remains one of the most severe stroke subtypes and requires continuous risk assessment across the acute, subacute, and rehabilitation-transition phases. This review summarizes established and emerging immune-related circulating biomarkers and discusses their relevance to nursing management and prognostic assessment. Markers with the highest current clinical readiness include peripheral blood cell counts and derived ratios, C-reactive protein (CRP), and procalcitonin (PCT), whereas cytokines, chemokines, broader immunometabolic mediators, and neuroinjury-inflammation cross-over markers remain mainly investigational. On the basis of the revised synthesis, we propose a stage-specific monitoring framework that emphasizes sampling at admission, approximately 24 hours, approximately 72 hours, and at clinically triggered reassessment points, together with interpretation of trajectories rather than isolated values. We further outline practice-oriented nursing scenarios in which biomarker trends may support escalation of neurologic observation, infection surveillance, airway care, glucose and nutrition management, structured handoff communication, and multidisciplinary coordination. Current evidence suggests that routinely available biomarkers may add value as adjunctive monitoring tools, but the literature remains limited by observational designs, heterogeneous assay platforms, inconsistent sampling windows, variable endpoints, incomplete confounder control, and uncertain action thresholds. At present, biomarkers should complement rather than replace imaging, neurological examination, and bedside nursing assessment. Future prospective studies should prioritize standardized sampling, trajectory-based analyses, integration into nursing workflows, and clinically interpretable multimodal models.