Alina Vilkė, Vilma Traškaitė, Diana Bilskienė, Indrė Jarutienė, Vaiva Skaraitė, Rimantas Vilcinis, Arimantas Tamašauskas, Andrius Macas
Abstract
Introduction. Traumatic brain injury (TBI) is a heterogeneous pathological condition including a wide range of clinical disorders. Due to diversity of outcomes, prognosis becomes the integral part of the clinical care of TBI patients. A number of brain-specific biochemical markers are available but S100B and neuron specific enolase (NSE) were chosen for the prediction of in-hospital mortality after severe TBI as they have been widely used and investigated by other neuroscientists. The main aim of this research was to evaluate S100B and NSE prediction capacity of mortality and long term survival in patients after traumatic brain injury (TBI). Materials and methods. A prospective observational study was held in Anaesthesiology clinic of Lithuanian University of Health sciences, Neurosurgery department from 2013 to 2017. 183 adult patients (aged >18 years) suffering from TBI with the need of urgent surgery were involved in the study. Blood samples for neuromarkers investigation were obtained at hospital admission and 24, 48 and 72 hours’ after hospital admission. All p values <0.05 were considered statistically significant. Results. Mean concentrations of both neuromarkers were measured and compared among each measurement. Concentrations of both neuromarkers of all four measurements were also compared between those patients who survived and those who died in hospital. Statistically significant difference was found in N3 and N4 measurements of both NSE and S100B and in N2 measurement of S100B. All four measurements of both neuromarkers differed significantly among those who survived and those who died in long term survival perspective. ROC curve analysis was used to define particular cut-off values for each measurement. Concentrations of each neuromarker were compared between those patients who died in hospital and those who survived. Conclusion. S100B and NSE are reliable predictors of long term survival for patients who experienced TBI, although neuromarker S100B is defined as a slightly better and more reliable predictor of in-hospital mortality.
Keyword(s): traumatic brain injury; neuromarkers; mortality prediction; outcome prediction; S100B; neuron specific enolase.
DOI: 10.5200/sm-hs.2017.027
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