The effect of age and sex on outcomes following isolated moderate to severe traumatic brain injury

Abstract Objectives Severe traumatic brain injury (sTBI) patients suffer high mortality. Accurate prognostic biomarkers have not been identified. In this exploratory study, we performed targeted proteomics on plasma obtained from sTBI patients to identify potential outcome biomarkers. Methods Blood sample was collected from patients admitted to the ICU suffering a sTBI, using standardized clinical and computerized tomography (CT) imaging criteria. Age- and sex-matched healthy control subjects and sTBI patients were enrolled. Targeted proteomics was performed on plasma with proximity extension assays (1,161 proteins). Results Cohorts were well-balanced for age and sex. The majority of sTBI patients were injured in motor vehicle collisions and the most frequent head CT finding was subarachnoid hemorrhage. Mortality rate for sTBI patients was 40%. Feature selection identified the top performing 15 proteins for identifying sTBI patients from healthy control subjects with a classification accuracy of 100%. The sTBI proteome was dominated by markers of vascular pathology, immunity/inflammation, cell survival and macrophage/microglia activation. Receiver operating characteristic (ROC) curve analyses demonstrated areas-under-the-curves (AUC) for identifying sTBI that ranged from 0.870-1.000 (p≤0.005). When mortality was used as outcome, ROC curve analyses identified the top 3 proteins as vWF, WIF-1, and CSF-1. Combining vWF with either WIF-1 or CSF-1 resulted in excellent mortality prediction with AUC of 1.000 for both combinations (p=0.011). Conclusions Targeted proteomics with feature classification and selection distinguished sTBI patients from matched healthy control subjects. Two protein combinations were identified that accurately predicted sTBI patient mortality. Our exploratory findings require confirmation in larger sTBI patient populations.

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The effect of age-at-testing on verbal memory among children following severe traumatic brain injury

Child Neuropsychology ◽

10.1080/09297049.2015.1028348 ◽

2015 ◽

Vol 22 (5) ◽

pp. 600-617 ◽

Cited By ~ 2

Author(s):

Tamar Silberg ◽

Jaana Ahonniska-Assa ◽

Miriam Levav ◽

Roni Eliyahu ◽

Tamar Peleg-Pilowsky ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Verbal Memory ◽

Effect Of Age

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The effect of age at injury and socio-economic status on recovery after childhood severe traumatic brain injury: Results of a prospective study

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2012.07.908 ◽

2012 ◽

Vol 55 ◽

pp. e358-e359

Author(s):

M. Chevignard ◽

M. De Agostini ◽

S. Escolano ◽

A. Laurent-Vannier ◽

S. Lancien ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Prospective Study ◽

Severe Traumatic Brain Injury ◽

Economic Status ◽

Socio Economic Status ◽

A Prospective Study ◽

Effect Of Age

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Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph14111378 ◽

2017 ◽

Vol 14 (11) ◽

pp. 1378 ◽

Cited By ~ 8

Author(s):

Cheng-Shyuan Rau ◽

Shao-Chun Wu ◽

Yi-Chun Chen ◽

Peng-Chen Chien ◽

Hsiao-Yun Hsieh ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Propensity Score ◽

Glasgow Coma Scale ◽

Severe Traumatic Brain Injury ◽

Coma Scale ◽

Effect Of Age

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Association of Age and Sex With Multi-Modal Cerebral Physiology in Adult Moderate/Severe Traumatic Brain Injury: A Narrative Overview and Future Avenues for Personalized Approaches

Frontiers in Pharmacology ◽

10.3389/fphar.2021.676154 ◽

2021 ◽

Vol 12 ◽

Author(s):

C. Batson ◽

A. Gomez ◽

A. S. Sainbhi ◽

L. Froese ◽

F. A. Zeiler

Keyword(s):

Traumatic Brain Injury ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

High Frequency ◽

Biological Sex ◽

Severe Tbi ◽

Cerebral Physiology ◽

Age And Sex

The impact of age and biological sex on outcome in moderate/severe traumatic brain injury (TBI) has been documented in large cohort studies, with advanced age and male sex linked to worse long-term outcomes. However, the association between age/biological sex and high-frequency continuous multi-modal monitoring (MMM) cerebral physiology is unclear, with only sparing reference made in guidelines and major literature in moderate/severe TBI. In this narrative review, we summarize some of the largest studies associating various high-frequency MMM parameters with age and biological sex in moderate/severe TBI. To start, we present this by highlighting the representative available literature on high-frequency data from Intracranial Pressure (ICP), Cerebral Perfusion Pressure (CPP), Extracellular Brain Tissue Oxygenation (PbtO2), Regional Cerebral Oxygen Saturations (rSO2), Cerebral Blood Flow (CBF), Cerebral Blood Flow Velocity (CBFV), Cerebrovascular Reactivity (CVR), Cerebral Compensatory Reserve, common Cerebral Microdialysis (CMD) Analytes and their correlation to age and sex in moderate/severe TBI cohorts. Then we present current knowledge gaps in the literature, discuss biological implications of age and sex on cerebrovascular monitoring in TBI and some future avenues for bedside research into the cerebrovascular physiome after TBI.

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The Effect of Age and Pain on Quantitative Sensory Testing Measurements After Moderate-to-Severe Traumatic Brain Injury: Preliminary Findings

Biological Research For Nursing ◽

10.1177/1099800420912462 ◽

2020 ◽

Vol 22 (3) ◽

pp. 341-353

Author(s):

Sabrina Bouferguene ◽

Alexandra Lapierre ◽

Pierre Rainville ◽

Caroline Arbour

Keyword(s):

Traumatic Brain Injury ◽

Chronic Pain ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Quantitative Sensory Testing ◽

Age Groups ◽

Sensory Testing ◽

Body Regions ◽

Severe Tbi ◽

Effect Of Age

Background: Chronic pain after moderate-to-severe traumatic brain injury (TBI) is associated with notable sensory alterations. Although the incidence of TBI is rapidly growing in older populations, elderly individuals have been largely excluded from sensory testing studies, thus limiting evidence regarding the influence of age on pain-related sensory alterations after TBI. This study aimed to investigate the effect of age on the sensory profiles of patients with and without chronic pain after moderate-to-severe TBI. Methods: Thermal and mechanical quantitative sensory testing were performed on the painful and contralateral body regions in TBI participants with pain (TBI-P) and on both forearms in TBI participants without pain (TBI-NP). Descriptive information about chronic pain and psychological comorbidities was assessed using validated questionnaires. Results: Participants included 37 young (18–59 years, 57% with chronic pain) and 22 elderly (≥60 years, 46% with chronic pain) survivors of moderate-to-severe TBI. TBI-P participants exhibited significant alterations in heat and pressure pain sensitivity compared to TBI-NP participants, with more pronounced decreases in heat detection in the elderly group and increased warmth sensitivity in the young group. Alterations were not always associated with chronic pain, as cold hypoesthesia was found in elderly TBI-NP participants. In both age groups, chronic pain was associated with higher levels of depressive mood. Conclusions: Results suggest that young and elderly TBI survivors have both common and unique sensory properties, highlighting the need to pursue sensory testing studies in older patient groups. Depression might also be an important target for pain management after TBI.

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