Diagnostic value of S100B and neuron-specific enolase in mild pediatric traumatic brain injury

2009 ◽  
Vol 4 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Christian Geyer ◽  
Anett Ulrich ◽  
Gerd Gräfe ◽  
Barbara Stach ◽  
Holger Till
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Trauma ◽  
Clinical Signs ◽  
Neuron Specific Enolase ◽  
Minor Head Trauma ◽  
Mild Tbi ◽  
Asymptomatic Children ◽  
Significant Difference ◽  
Gcs Score

Object During recent years, several biomarkers have been introduced for use in the diagnosis of traumatic brain injury (TBI). The primary objective of this investigation was to determine if S100B (or S100 calcium-binding protein B) and neuron-specific enolase (NSE) serum concentrations can effectively be used to discriminate between symptomatic and asymptomatic children with minor head trauma. Methods The authors conducted a prospective clinical study that involved patients age 6 months to 15 years who had sustained minor head trauma. Children with concomitant extracranial injuries were excluded. Blood samples were obtained within 6 hours of injury to measure S100B and NSE levels in serum. The authors defined 2 diagnostic groups: a mild TBI group (patients with Glasgow Coma Scale [GCS] scores of 13–15) in whom there were clinical signs of concussion (short loss of consciousness, amnesia, nausea, vomiting, somnolence, headache, dizziness, or impaired vision) and a head contusion group (patients with a GCS score of 15) in whom symptoms were absent. Both S100B and NSE concentrations were compared between the 2 groups. Secondary end points were defined as follows: correlation of S100B/NSE and a) the presence of scalp lacerations, b) GCS score, c) age, and d) correlation between S100B and NSE. Results One hundred forty-eight patients were enrolled (53 in the contusion group, 95 in the mild TBI group). After adjusting for differences in age and time of injury to blood sample withdrawal, there was no significant difference in S100B or NSE between patients in the 2 groups. Scalp lacerations and GCS score had no affect on posttraumatic S100B or NSE concentrations. The correlation between S100B and NSE was significant. Both markers showed a significant negative correlation with age. Conclusions The authors demonstrated that S100B and NSE do not discriminate between symptomatic and asymptomatic children with minor head injury. There seem to be limitations in marker sensitivity when investigating pediatric patients with mild TBI.

Antithrombotic agents and traumatic brain injury in the elderly population: hemorrhage patterns and outcomes

2020 ◽  
Vol 133 (2) ◽  
pp. 486-495 ◽  
Author(s):  
Pasquale Scotti ◽  
Chantal Séguin ◽  
Benjamin W. Y. Lo ◽  
Elaine de Guise ◽  
Jean-Marc Troquet ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Trauma ◽  
Ct Scanning ◽  
The Elderly ◽  
International Normalized Ratio ◽  
Trauma Patients ◽  
Risk Of Falls ◽  
Gcs Score

OBJECTIVEAmong the elderly, use of antithrombotics (ATs), antiplatelets (APs; aspirin, clopidogrel), and/or anticoagulants (ACs; warfarin, direct oral ACs [DOACs; dabigatran, rivaroxaban, apixaban]) to prevent thromboembolic events must be carefully weighed against the risk of intracranial hemorrhage (ICH) with trauma. The goal of this study was to assess the risk of sustaining a traumatic brain injury (TBI), ICH, and poorer outcomes in relation to AT use among all patients 65 years or older presenting to a single institution with head trauma.METHODSData were collected from all head trauma patients 65 years or older presenting to the authors’ supraregional tertiary trauma center over a 24-month period and included age, sex, injury mechanism, medical history, international normalized ratio, Glasgow Coma Scale (GCS) score, ICH presence and type, hospital admission, reversal therapy, surgery, discharge destination, Extended Glasgow Outcome Scale (GOSE) score at discharge, and mortality.RESULTSA total of 1365 head trauma patients 65 years or older were included; 724 were on AT therapy (413 on APs, 151 on ACs, 59 on DOACs, 48 on 2 APs, 38 on AP+AC, and 15 on AP+DOAC) and 641 were not. Among all head trauma patients, the risk of sustaining a TBI was associated with AP use after adjusting for covariates. Of the 731 TBI patients, those using ATs had higher rates of ICH (p <0.0001), functional dependency at discharge (GOSE score ≤ 4; p < 0.0001), and mortality (p < 0.0001). Elevated rates of ICH progression on follow-up CT scanning were observed in patients in the warfarin monotherapy (OR 5.30, p < 0.0001) and warfarin + AP (OR 6.15, p = 0.0011). Risk of mortality was not associated with single antiplatelet use but was notably high with 2 APs (OR 4.66, p = 0.0056), warfarin (OR 5.18, p = 0.0003), and DOAC use (OR 5.09, p = 0.0149).CONCLUSIONSElderly trauma patients on ATs, especially combination therapy, are at elevated risk of ICH and poor outcomes compared with those not on AT therapy. While both AP and warfarin use alone and in combination were associated with significantly elevated odds of sustaining an ICH among TBI patients, only warfarin use was a predictor of hemorrhage progression on follow-up scans. The use of a single AP was not associated with mortality; however, the combination of both aspirin and clopidogrel was. Warfarin and DOAC users had comparable mortality rates; however, DOAC users had lower rates of ICH progression, and fewer survivors were functionally dependent at discharge than were warfarin users. DOACs are an overall safer alternative to warfarin for patients at high risk of falls.

scholarly journals Identification of practically important traumatic brain injury using Pediatric Emergency Care Applied Research Network rule in children younger than 2 years with minor head trauma

2020 ◽  
pp. 102490792097537
Author(s):  
Jon Soo Kim ◽  
Jin Cheol Kim ◽  
Won Young Sung
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Head Trauma ◽  
Emergency Care ◽  
Applied Research ◽  
Pediatric Emergency ◽  
Research Network ◽  
Minor Head Trauma ◽  
Pediatric Emergency Care

Background: Minor head trauma is frequently presented to the pediatric emergency department. Despite the burden this injury poses on public health, evidence-based clinical guidelines on the assessment and management of pediatric minor head trauma remain unestablished, particularly in children below 2 years. We aimed to assess the diagnostic accuracy of a clinical decision rule (Pediatric Emergency Care Applied Research Network rule) and physician discretion in the recognition of practically important traumatic brain injury in children below 2 years of age presenting with minor head trauma to the emergency department. Methods: The medical records of children younger than 2 years presenting with head trauma to the emergency department were reviewed with Glasgow Coma Scale scores of 14–15. Practically important traumatic brain injury is a clinically essential traumatic brain injury including all cranial abnormalities (e.g. skull fracture) detected by computed tomography. All predictor variables of the Pediatric Emergency Care Applied Research Network rule and practically important traumatic brain injury outcomes were validated. Results: We enrolled and analyzed 433 children below 2 years. The most frequently observed mechanisms of injury in decreasing order were as follows: falls > 90 cm, head struck by high-impact objects, slip down, and automobile traffic accident. Of 224 children, positive findings were observed in 35 and 144 had one or more predictors of Pediatric Emergency Care Applied Research Network rule. The sensitivity, specificity, and negative likelihood ratio of the Pediatric Emergency Care Applied Research Network rule for practically important traumatic brain injury were 94.3%, 41.3%, and 0.14, respectively. Conclusion: The Pediatric Emergency Care Applied Research Network rule would assist in clinical decision-making to appropriately detect potential head injuries in children below 2 years, thereby reducing unnecessary performance of computed tomography scan.

Are routine repeat imaging and intensive care unit admission necessary in mild traumatic brain injury?

2012 ◽  
Vol 116 (3) ◽  
pp. 549-557 ◽  
Author(s):  
Chad W. Washington ◽  
Robert L. Grubb
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ct Scans ◽  
Imaging Data ◽  
Inclusion Criteria ◽  
Mild Tbi ◽  
Head Ct ◽  
Gcs Score ◽  
Repeat Imaging ◽  
Neurosurgical Intervention

Object More than 1.5 million Americans suffer a traumatic brain injury (TBI) each year. Seventy-five percent of these patients have a mild TBI, with Glasgow Coma Scale (GCS) Score 13–15. At the authors' institution, the usual practice has been to admit those patients with an associated intracranial hemorrhage (ICH) to an ICU and to obtain repeat head CT scans 12–24 hours after admission. The purpose of this study was to determine if there exists a subpopulation of mild TBI patients with an abnormal head CT scan that requires neither repeat brain imaging nor admission to an ICU. This group of patients was further classified based on initial clinical factors and imaging characteristics. Methods A retrospective review of all patients admitted to a Level I trauma center from January 2007 through December 2008 was performed using the hospital Trauma Registry Database, medical records, and imaging data. The inclusion criteria were as follows: 1) an admission GCS score ≥ 13; 2) an isolated head injury with no other injury requiring ICU admission; 3) an initial head CT scan positive for ICH; and 4) an initial management plan that was nonoperative. Collected data included age, etiology, initial GCS score, time of injury, duration of ICU stay, duration of hospital stay, and anticoagulation status. Primary outcomes measured were the occurrence of neurological or medical decline and the need for neurosurgical intervention. Imaging data were analyzed and classified based on the predominant blood distribution found on admission imaging. Data were further categorized based on the Marshall CT classification, Rotterdam score, and volume of intraparenchymal hemorrhage (IPH). Progression was defined as an increase in the Marshall classification, an increase in the Rotterdam score, or a 30% increase in IPH volume. Results Three hundred twenty-one of 1101 reviewed cases met inclusion criteria for the study. Only 4 patients (1%) suffered a neurological decline and 4 (1%) required nonemergent neurosurgical intervention. There was a medical decline in 18 of the patients (6%) as a result of a combination of events such as respiratory distress, myocardial infarction, and sepsis. Both patient age and the transfusion of blood products were significant predictors of medical decline. Overall patient mortality was 1%. Based on imaging data, the rate of injury progression was 6%. The only type of ICH found to have a significant rate of progression (53%) was a subfrontal/temporal intraparenchymal contusion. Other variables found to be significant predictors of progression on head CT scans were the use of anticoagulation, an age over 65 years, and a volume of ICH > 10 ml. Conclusions Most patients with mild TBI have a good outcome without the necessity of neurosurgical intervention. Mild TBI patients with a convexity SAH, small convexity contusion, small IPH (≤ 10 ml), and/or small subdural hematoma do not require admission to an ICU or repeat imaging in the absence of a neurological decline.

Head Trauma in the Cat: 2. Assessment and Management of Traumatic Brain Injury

2011 ◽  
Vol 13 (11) ◽  
pp. 815-823 ◽  
Author(s):  
Laurent Garosi ◽  
Sophie Adamantos
Keyword(s):  
Traumatic Brain Injury ◽  
General Practice ◽  
Brain Injury ◽  
Head Trauma ◽  
Brain Injuries ◽  
Experimental Studies ◽  
Clinical Signs ◽  
Evidence Base ◽  
Neurological Deficits ◽  
Current Evidence

Practical relevance Feline trauma patients are commonly seen in general practice and frequently have sustained some degree of brain injury. Clinical challenges Cats with traumatic brain injuries may have a variety of clinical signs, ranging from minor neurological deficits to life-threatening neurological impairment. Appropriate management depends on prompt and accurate patient assessment, and an understanding of the pathophysiology of brain injury. The most important consideration in managing these patients is maintenance of cerebral perfusion and oxygenation. For cats with severe head injury requiring decompressive surgery, early intervention is critical. Evidence base There is a limited clinical evidence base to support the treatment of traumatic brain injury in cats, despite its relative frequency in general practice. Appropriate therapy is, therefore, controversial in veterinary medicine and mostly based on experimental studies or human head trauma studies. This review, which sets out to describe the specific approach to diagnosis and management of traumatic brain injury in cats, draws on the current evidence, as far as it exists, as well as the authors' clinical experience.

scholarly journals Medical necessity of routine admission of children with mild traumatic brain injury to the intensive care unit

2017 ◽  
Vol 19 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Jared D. Ament ◽  
Krista N. Greenan ◽  
Patrick Tertulien ◽  
Joseph M. Galante ◽  
Daniel K. Nishijima ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Stepwise Logistic Regression ◽  
Mild Tbi ◽  
Misclassification Cost ◽  
Gcs Score

OBJECTIVEApproximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13–15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care.METHODSThe authors retrospectively reviewed patients with mild TBI who were ≤ 16 years old and who presented to a Level 1 trauma center between 2008 and 2013. Data were abstracted from institutional TBI and trauma registries. Independent covariates included age, GCS score, pupillary response, CT characteristics, and Injury Severity Score. A composite outcome measure, ICU-level care, was defined as cardiopulmonary instability, transfusion, intubation, placement of intracranial pressure monitor or other invasive monitoring, and/or need for surgical intervention. Stepwise logistic regression defined significant predictors for model inclusion with p < 0.10. The authors derived the CDR with binary recursive partitioning (using a misclassification cost of 20:1).RESULTSA total of 284 patients with mild TBI were included in the analysis; 40 (14.1%) had ICU-level care. The CDR consisted of 5 final predictor variables: midline shift > 5 mm, intraventricular hemorrhage, nonisolated head injury, postresuscitation GCS score of < 15, and cisterns absent. The CDR correctly identified 37 of 40 patients requiring ICU-level care (sensitivity 92.5%; 95% CI 78.5–98.0) and 154 of 244 patients who did not require an ICU-level intervention (specificity 63.1%; 95% CI 56.7–69.1). This results in a negative predictive value of 98.1% (95% CI 94.1–99.5).CONCLUSIONSThe authors derived a clinical tool that defines a subset of pediatric patients with mild TBI at low risk for ICU-level care. Although prospective evaluation is needed, the potential for improved resource allocation is significant.

scholarly journals The validity of Protein S 100B in Mild Pediatric Head Trauma

2021 ◽  
pp. 29
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Trauma ◽  
Pediatric Patients ◽  
Head Injuries ◽  
Protein S ◽  
S100b Protein ◽  
Pediatric Head Trauma ◽  
Significant Difference ◽  
A Prospective Study

Background; S100B has been shown to be beneficial as a biomarker in the treatment of adults with mild traumatic brain injury (mTBI). The efficacy of S100B as a biomarker in children, on the other hand, has been a subject of debate. Aim and objectives; was to assess the validity of Protein S 100B in Mild Pediatric Head trauma. Subjects and methods; this was a prospective study, included 160 pediatric patients with mild head trauma presented to Emergency Department. Result; A highly significant correlation between Positive S100B protein and traumatic brain injury with S100B protein value 1554.1±84.0 ng/L. A100 had cutoff value for positive CT Brain finding above 987.5 ng/L, The sensitivity was 81.0%, the specificity was 75%%, the NPV was 86%, the PPV was 68%, and overall accuracy 77%. There was none statistical significant difference regarding severity of brain injury and S100 B (P = 0.225), Conclusion; Serum S100B levels cannot be used to substitute clinical examinations or CT scans in identifying pediatric patients with mild head injuries, but they can be used to identify low-risk kids to avoid excessive radiation exposure.

Vomito nel trauma cranico e ondansetron: quali rischi e quali possibili benefici?

2020 ◽  
Vol 23 (10) ◽  
pp. 252-255
Author(s):  
Angela Troisi ◽  
Alessandra Iacono ◽  
Camilla Lama ◽  
Federico Marchetti
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Trauma ◽  
Skull Fracture ◽  
Sampling Period ◽  
Common Symptom ◽  
Minor Head Trauma ◽  
Intracranial Injury ◽  
Prospective Cohort Studies

In children minor head trauma is one of the most frequent reasons for presentation to emergency departments and clinicians’ main goal is the prompt identification of any traumatic brain injury that requires immediate treatment. Vomiting is a common symptom after a head trauma at any age, but the incidence of traumatic brain injury without other symptoms and/or signs of head injury is infrequent. This article evaluates a review recently published in the literature on the possibility and risks of administering ondansetron in paediatric patients with vomiting after minor head trauma. The review suggests that there is no association between ondansetron administration and the risk of masking a serious intracranial injury or skull fracture. Furthermore, studies show a significant increase in the use of the drug in the context of head trauma over the course of the sampling period. However, the studies have limitations, so the results should be interpreted with caution, waiting for multicentre and prospective cohort studies.

Neuropsychological and Psychiatric Outcomes of Traumatic Brain Injury in Children

2010 ◽  
Author(s):  
Jeffrey E. Max ◽  
Farheen Ibrahim
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Lesion ◽  
Mild Tbi ◽  
Computed Tomographic ◽  
Excitatory Neurotransmitters ◽  
Focal Brain Injury ◽  
Secondary Injuries ◽  
The Moment ◽  
Gcs Score

Pediatric traumatic brain injury (TBI) is a major health concern, with an annual incidence of 400 in 100,000 and it is the major cause of disability and death in children in the United States (Langlois, Rutland-Brown, and Thomas 2005). The Glasgow Coma Scale (GCS) (Teasdale and Jennett 1974) is a standard measure of severity of impaired consciousness, and it is used as a measure of TBI severity. Mild TBI is generally defined by the lowest post-resuscitation GCS score of 13–15, but many investigators have also stipulated that a mild TBI is defined by a normal computed tomographic (CT) scan within 24 hours after injury or at least no CT evidence of a brain lesion. Moderate injury has a GCS score of 9–12 or a score of 13–15 with an intracranial lesion. Severe injury has a GCS score of 8 or lower, consistent with coma. The pathology of TBI can be classified into diffuse and focal brain injury, although both types of injury can coexist in the same patient. Focal brain injury is characterized by mechanical forces that produce localized primary lesions that occur at the moment of trauma, such as cortical contusions. In closed head injuries, these forces can also produce hemorrhage in the epidural, subdural, subarachnoid, or intracerebral compartments of the cranium. Diffuse brain injury, more common in children than in adults with severe TBI, is caused by rapid movement of the head due to acceleration, deceleration, and rotational forces, which causes primary axonal injury, such as axonal stretch and shearing. Occurring immediately after trauma and producing effects that may progress over time, secondary injuries include ischemia, brain swelling, breakdown of the blood- brain barrier, release of excitatory neurotransmitters, generation of free radicals, cellular death and dysfunction, hypoxemia, and seizures. Hypotension is a serious complication of TBI and a challenge for acute neurocritical care (Kochanek 2006).

scholarly journals The impact of attention deficit hyperactivity disorder on recovery from mild traumatic brain injury

2013 ◽  
Vol 12 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Christopher M. Bonfield ◽  
Sandi Lam ◽  
Yimo Lin ◽  
Stephanie Greene
Keyword(s):  
Traumatic Brain Injury ◽  
Attention Deficit Hyperactivity Disorder ◽  
Brain Injury ◽  
Head Injury ◽  
Attention Deficit ◽  
Mild Tbi ◽  
Hyperactivity Disorder ◽  
Gcs Score ◽  
The Impact

Object Attention deficit hyperactivity disorder (ADHD) and traumatic brain injury (TBI) are significant independent public health concerns in the pediatric population. This study explores the impact of a premorbid diagnosis of ADHD on outcome following mild TBI. Methods The charts of all patients with a diagnosis of mild closed head injury (CHI) and ADHD who were admitted to Children's Hospital of Pittsburgh between January 2003 and December 2010 were retrospectively reviewed after institutional review board approval was granted. Patient demographics, initial Glasgow Coma Scale (GCS) score, hospital course, and King's Outcome Scale for Childhood Head Injury (KOSCHI) score were recorded. The results were compared with a sample of age-matched controls admitted with a diagnosis of CHI without ADHD. Results Forty-eight patients with mild CHI and ADHD, and 45 patients with mild CHI without ADHD were included in the statistical analysis. Mild TBI due to CHI was defined as an initial GCS score of 13–15. The ADHD group had a mean age of 12.2 years (range 6–17 years), and the control group had a mean age of 11.14 years (range 5–16 years). For patients with mild TBI who had ADHD, 25% were moderately disabled (KOSCHI Score 4b), and 56% had completely recovered (KOSCHI Score 5b) at follow-up. For patients with mild TBI without ADHD, 2% were moderately disabled and 84% had completely recovered at follow-up (p < 0.01). Patients with ADHD were statistically significantly more disabled after mild TBI than were control patients without ADHD, even when controlling for age, sex, initial GCS score, hospital length of stay, length of follow-up, mechanism of injury, and presence of other (extracranial) injury. Conclusions Patients who sustain mild TBIs in the setting of a premorbid diagnosis of ADHD are more likely to be moderately disabled by the injury than are patients without ADHD.

scholarly journals Hubungan antara Skor GCS dengan Kadar C-Reactive Protein (CRP) Pasien Cedera Otak Traumatik di IGD RSUD Ulin Banjarmasin

2019 ◽  
Vol 8 (3) ◽  
pp. 153-59
Author(s):  
Gusti Muhammad Fuad Suharto ◽  
Kenanga M Sikumbang ◽  
Dewi I N Pratiwi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
General Hospital ◽  
C Reactive Protein ◽  
Mild Tbi ◽  
Reactive Protein ◽  
Consecutive Sampling ◽  
Severe Tbi ◽  
Gcs Score ◽  
Post Hoc

AbstrakLatar Belakang dan Tujuan: Pada cedera otak traumatik (COT) terjadi perubahan tingkat kesadaran dan neurologis pasien, sehingga perlu dilakukan penilaian skor GCS untuk mengkategorikan tingkat keparahan COT. Saat terjadinya COT, akibat dari pengeluaran mediator inflamasi, hati akan mengeluarkan suatu penanda pertama inflamasi, yaitu c-reactive protein (CRP). Tujuan penelitian ini untuk mengetahui apakah terdapat hubungan antara skor GCS dengan kadar CRP pasien COT di IGD RSUD Ulin Banjarmasin. Subjek dan Metode: Penelitian ini menggunakan studi desain observasional analitik dengan rancangan potong lintang. Data diambil secara prospektif dengan metode consecutive sampling pada pasien COT yang masuk ke  IGD RSUD Ulin Banjarmasin periode Juli-September 2018 yang memenuhi kriteria inklusi dan eksklusiHasil:Didapatkan 53 subjek terdiri dari 42 pasien laki-laki dan 11 pasien perempuan dengan distribusi 22 (41,5%) pasien COT ringan, 20 (37,7%) pasien COT sedang, dan 11 (20,8%) pasien COT berat. Pengukuran kadar CRP didapatkan rata-rata 4,64 mg/l pada COT ringan, 18,00 mg/l pada COT sedang, dan 26,73 mg/dl pada COT berat. Analisis data menggunakan uji Kruskal-Wallis dengan tingkat kepercayaan 95% menunjukan peningkatan kadar CRP seiring dengan semakin beratnya COT (p=0,034), analisis Post Hoc menggunakan Mann-Whitney Test didapatkan perbedaan bermakna peningkatan kadar CRP antara pasien COT sedang berat dibandingkan COT ringan. Simpulan: Terdapat hubungan antara skor GCS dengan kadar CRP pada pasien cedera otak traumatik.Correlations between GCS Score and C-Reactive Protein (CRP) in Patients with Traumatic Brain Injury at Emergency Departement of Ulin General Hospital BanjarmasinAbstractBackgound and Objective: In traumatic brain injury (TBI), the level of severity could be assessed by GCS, so it is necessary to measure the GCS score to categorize the severity of TBI. TBI may followed by inflammatory mediators cell and one of inflammation marker released by liver, namely c-reactive protein (CRP).The purpose of this study is to analyze correlation between GCS scores and CRP levels in patients with traumatic brain injury at the emergency departement of Ulin General Hospital Banjarmasin. Subject and Method: This study is a analytic observational study with cross sectional design. Data acquired prospectively with consecutive sampling method in TBI patients who entered the emergency department of Ulin General Hospital in the period from July-September 2018 that fulfilled inclusion criteria and exclusion criteria.Result: We obtained 53 subjects consisted of 42 males and 11 females with a distribution of 22 (41.5%) mild TBI patients, 20 (37.7%) modarate TBI patients, and 11 (20,8%) severe TBI patients. Measurements of CRP levels were obtained at an averange of 4.64 mg/l in mild TBI, 18.00 mg/l in moderate TBI, and 26.73 mg/l in severe TBI. There was correlation between the increasing of CRP levels with severity of TBI using Kruskal-Wallis test with a confidence level of 95% (p=0.034), in Post Hoc analysis using Mann-Whitney test, there was significant differences in elevated CRP levels between moderate-severe TBI patients compared to mild TBI patients. Conclusion: It was concluded that there was a corellation between GCS scores and CRP levels in TBI patients.

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