scholarly journals Persephin as a diagnostic marker of acute brain injury in critically ill newborns: a clinical trial

2021 ◽  
Vol 6 (3) ◽  
pp. 15-24
Author(s):  
A. A. Zadvornov ◽  
E. V. Grigoriev
Keyword(s):  
Brain Injury ◽  
Brain Damage ◽  
Critically Ill ◽  
Serum Protein ◽  
Cerebral Edema ◽  
Apgar Score ◽  
Prognostic Significance ◽  
Rank Correlation ◽  
Unfavorable Outcome ◽  
Protein S100b

Aim. To study the correlation of serum persephin with clinical, instrumental and biochemical indicators of brain damage and with an adverse outcome in critically ill newborns.Materials and Methods. The study included 44 critically ill newborns. Blood samples were collected on the 1st and 7th day of life. Brain injury was assessed by recording Apgar score, depression of consciousness and brainstem reflexes in unsedated patients over 7 days of life, convulsions, neurosonographic signs of cerebral edema, serum protein S100B on the 1st and 7th day of life, and using indicators of adverse neurological outcome. The correlation of serum persephin on the 1st and 7th day of life with signs of brain damage was evaluated using the Spearman's rank correlation coefficient and Mann-Whitney U-test.Results. No statistically significant correlation was found between the concentrations of serum persephin on the 1st and 7th day of life and Apgar score (p = 0.721 and 0.222, respectively), depression of consciousness and stem reflexes (p < 0.05), convulsions (p = 0.673 and 0.432, respectively), cerebral edema (p = 0.737 and 0.558, respectively), and serum protein S100B both on the 1st day (p = 0.095 and 0.475, respectively) and 7th day of life (p = 0.988 and p = 0.775, respectively). Further, there was no statistically significant association of the serum persephin on the 1st day of line with an unfavorable outcome (p = 0.294). Yet, we revealed an association of serum persephin on the 7th day of life with an unfavorable outcome (p = 0.013), with a cut-off point of 828 ng/mL, a sensitivity of 39%, and a specificity of 100%.Conclusion. Persephin has poor diagnostic and prognostic significance for assessing the severity of brain damage in critically ill newborns. The obtained data on the correlation of the concentration of persephin for 7 days with an unfavorable outcome are doubtful due to the lack of data on its correlation with signs of severe brain damage.

scholarly journals Elevated Serum Protein S100B and Neuron Specific Enolase Values as Predictors of Early Neurological Outcome after Traumatic Brain Injury

2017 ◽  
Vol 36 (4) ◽  
pp. 314-321 ◽  
Author(s):  
Branislava Stefanović ◽  
Olivera Đurić ◽  
Sanja Stanković ◽  
Srđan Mijatović ◽  
Krstina Doklestić ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Serum Protein ◽  
Neurological Outcome ◽  
Brain Injuries ◽  
Elevated Serum ◽  
Neuron Specific Enolase ◽  
Poor Outcome ◽  
Protein S100b ◽  
The Brain

SummaryBackground: The objective of our study was to determine the serum concentrations of protein S100B and neuron specific enolase (NSE) as well as their ability and accuracy in the prediction of early neurological outcome after a traumatic brain injury. Methods: A total of 130 polytraumatized patients with the associated traumatic brain injuries were included in this prospective cohort study. Serum protein S100B and NSE levels were measured at 6, 24, 48 and 72 hours after the injury. Early neurological outcome was scored by Glasgow Outcome Scale (GOS) on day 14 after the brain injury. Results: The protein S100B concentrations were maximal at 6 hours after the injury, which was followed by an abrupt fall, and subsequently slower release in the following two days with continual and significantly increased values (p<0.0001) in patients with poor outcome. Secondary increase in protein S100B at 72 hours was recorded in patients with lethal outcome (GOS 1). Dynamics of NSE changes was characterized by a secondary increase in concentrations at 72 hours after the injury in patients with poor outcome. Conclusion: Both markers have good predictive ability for poor neurological outcome, although NSE provides better discriminative potential at 72 hours after the brain injury, while protein S100B has better discriminative potential for mortality prediction.

Prognostic significance of abnormal hematological parameters in severe traumatic brain injury requiring decompressive craniectomy

2020 ◽  
Vol 132 (2) ◽  
pp. 545-551 ◽  
Author(s):  
Jade-Marie Corbett ◽  
Kwok M. Ho ◽  
Stephen Honeybul
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Prognostic Model ◽  
Prognostic Significance ◽  
Unfavorable Outcome ◽  
Severe Tbi ◽  
Hematological Abnormalities ◽  
The Impact ◽  
Predicted Risk

OBJECTIVEHematological abnormalities after severe traumatic brain injury (TBI) are common, and are associated with a poor outcome. Whether these abnormalities offer additional prognostic significance over and beyond validated TBI prognostic models is uncertain.METHODSThis retrospective cohort study compared the ability of admission hematological abnormalities to that of the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials) prognostic model to predict 18-month neurological outcome of 388 patients who required a decompressive craniectomy after severe TBI, between 2004 and 2016, in Western Australia. Area under the receiver operating characteristic (AUROC) curve was used to assess predictors’ ability to discriminate between patients with and without an unfavorable outcome of death, vegetative state, or severe disability.RESULTSOf the 388 patients included in the study, 151 (38.9%) had an unfavorable outcome at 18 months after decompressive craniectomy for severe TBI. Abnormalities in admission hemoglobin (AUROC 0.594, p = 0.002), plasma glucose (AUROC 0.592, p = 0.002), fibrinogen (AUROC 0.563, p = 0.036), international normalized ratio (INR; AUROC 0.645, p = 0.001), activated partial thromboplastin time (AUROC 0.564, p = 0.033), and disseminated intravascular coagulation score (AUROC 0.623, p = 0.001) were all associated with a higher risk of unfavorable outcome at 18 months after severe TBI. As a marker of inflammation, neutrophil to lymphocyte ratio was not significantly associated with the risk of unfavorable outcome (AUROC 0.500, p = 0.998). However, none of these parameters, in addition to the platelet count, were significantly associated with an unfavorable outcome after adjusting for the IMPACT predicted risk (odds ratio [OR] per 10% increment in risk 2.473, 95% confidence interval [CI] 2.061–2.967; p = 0.001). After excluding 8 patients (2.1%) who were treated with warfarin prior to the injury, there was a suggestion that INR was associated with some additional prognostic significance (OR 3.183, 95% CI 0.856–11.833; p = 0.084) after adjusting for the IMPACT predicted risk.CONCLUSIONSIn isolation, INR was the best hematological prognostic parameter in severe TBI requiring decompressive craniectomy, especially when patients treated with warfarin were excluded. However, the prognostic significance of admission hematological abnormalities was mostly captured by the IMPACT prognostic model, such that they did not offer any additional prognostic information beyond the IMPACT predicted risk. These results suggest that new prognostic factors for TBI should be evaluated in conjunction with predicted risks of a comprehensive prognostic model that has been validated, such as the IMPACT prognostic model.

scholarly journals Prognostic significance of age in traumatic brain injury

2012 ◽  
Vol 03 (02) ◽  
pp. 131-135 ◽  
Author(s):  
S S Dhandapani ◽  
D Manju ◽  
B S Sharma ◽  
A K Mahapatra
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Surgical Intervention ◽  
Prognostic Significance ◽  
Age Groups ◽  
Unfavorable Outcome ◽  
Confounding Factors ◽  
Age Group ◽  
Independent Association ◽  
The Impact

ABSTRACT Background: Age is a strong prognostic factor following traumatic brain injury (TBI), with discrepancies defining the critical prognostic age threshold. This study was undertaken to determine the impact of various age thresholds on outcome after TBI. Materials and Methods: The ages of patients admitted with TBI were prospectively studied in relation to mode of injury, Glasgow coma score (GCS), CT category and surgical intervention. Mortality was assessed at 1 month, and neurological outcome was assessed at 6 months. Appropriate statistical analyzes (details in article) were performed. Results: Of the total 244 patients enrolled, 144 patients had severe, 38 patients had moderate and 62 patients had mild TBI, respectively. Age had significant association with grade of injury, CT category and surgical intervention (P < 0.01). Mortality at 1 month was significantly associated with increasing age with patients dead at 1 month being 15% for age < 18, 44% for age between 18 and 59 years, and 52% in the age group > 59 years respectively (P < 0.001). Unfavorable outcome showed significant association with an increase in age, every decade (P < 0.001). In multivariate analysis, there was stepwise increase in the odds of unfavorable outcome across age groups centered on 40 years, independent of confounding factors. The adjusted odds ratios for unfavorable outcome with regard to age thresholds 30, 40 and 50 years were 11.3, 53.3 and 1171, respectively (P < 0.005). Moreover, there was significant association of unfavorable outcome with age > 40 years in all subgroups, based on GCS and surgical intervention (P < 0.05). Conclusions: In patients with TBI, age demonstrates independent association with unfavorable outcome at 6 months, in stepwise manner centered on a threshold of 40 years.

scholarly journals Modern problems of diagnostics and surgical treatment of patients with multifocal injuries of a brain with polytrauma

2008 ◽  
Vol 7 (5-2) ◽  
pp. 310-317
Author(s):  
A. O. Bumay
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Literature Review ◽  
Intracranial Hypertension ◽  
Brain Damage ◽  
Cerebral Edema ◽  
Morbidity And Mortality ◽  
Multiple Injuries ◽  
Secondary Brain Damage

Severe head traumas in combination with multiple injuries of polytrauma are important factors for the prognosis of morbidity and mortality in patients. The prognosis mainly depends on the presence of primary mechanic brain injury and the development of secondary brain damage. In patients with traumatic brain injury, intracranial hypertension against multifocal injuries secondary to cerebral edema is a major problem. We have made literature review.

Postmortem serum protein S100B levels with regard to the cause of death involving brain damage in medicolegal autopsy cases

2006 ◽  
Vol 8 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Dong-Ri Li ◽  
Bao-Li Zhu ◽  
Takaki Ishikawa ◽  
Dong Zhao ◽  
Tomomi Michiue ◽  
...  
Keyword(s):  
Brain Damage ◽  
Cause Of Death ◽  
Serum Protein ◽  
Medicolegal Autopsy ◽  
Protein S100b

Machine Learning for Prediction of Mortality and Unfavorable Outcome in Traumatic Brain Injury: A CENTER-TBI Study

2019 ◽  
Author(s):  
Benjamin Gravesteijn ◽  
Daan Nieboer ◽  
Ari Ercole ◽  
Hester F. Lingsma ◽  
David Nelson ◽  
...  
Keyword(s):  
Machine Learning ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Unfavorable Outcome ◽  
Prediction Of Mortality

scholarly journals Intracranial Pressure during External Ventricular Drainage Weaning Is an Outcome Predictor of Traumatic Brain Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jia-cheng Gu ◽  
Hong Wu ◽  
Xing-zhao Chen ◽  
Jun-feng Feng ◽  
Guo-yi Gao ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
External Ventricular Drainage ◽  
Unfavorable Outcome ◽  
Ventricular Drainage ◽  
Outcome Group ◽  
Significant Difference ◽  
The Mean ◽  
The Relationship

External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disability). Groups were well matched for sex, pupil reactivity, admission Glasgow Coma Scale score, Marshall computed tomography score, modified Fisher score, intraventricular hemorrhage, EVD days, cerebrospinal fluid output before the weaning trial, and the complications. Before and during the weaning trial, we recorded the ICP at 1-hour intervals to calculate the mean ICP, delta ICP, and ICP burden, which was defined as the area under the ICP curve. There were significant between-group differences in the age, surgery types, and intensive care unit days (p=0.045, p=0.028, and p=0.004, respectively). During the weaning trial, 28 (75.7%) patients had an increased ICP. Although there was no significant difference in the mean ICP before and during the weaning trial, the delta ICP was higher in the unfavorable outcome group (p=0.001). Moreover, patients who experienced death and hydrocephalus had a higher ICP burden, which was above 20 mmHg (p=0.016). Receiver operating characteristic analyses demonstrated the predictive ability of these variables (area under the curve AUC=0.818 [p=0.002] for delta ICP and AUC=0.758 [p=0.038] for ICP burden>20 mmHg). ICP elevation is common during EVD weaning trials in patients with TBI. ICP-related parameters, including delta ICP and ICP burden, are significant outcome predictors. There is a need for larger prospective studies to further explore the relationship between ICP during EVD weaning trials and TBI outcomes.

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