Citation

Lorente L, Martín MM, González-Rivero AF, Ramos L, Argueso M, Cáceres JJ, Solé-Violán J, Jiménez A, Borreguero-León JM, García-Marín V. World Neurosurg. 2019; ePub(ePub): ePub.

Affiliation

Deparment of Neurosurgery. Hospital Universitario de Canarias. Ofra, s/n. La Laguna - 38320. Santa Cruz de Tenerife. Spain.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.wneu.2019.03.179

PMID

30926559

Abstract

BACKGROUND: Soluble cluster of differentiation 40 ligand (sCD40L) is a member of the tumor necrosis factor family with proinflamatory and procoagulant effects. A previous study found higher serum sCD40L levels at day 1 of traumatic brain injury (TBI) in non-surviving than in surviving patients. Thus, the objective of this study was to compare serum sCD40L levels during the first week of a severe TBI between surviving and non-surviving patients and to determine whether it could be used as a mortality predictor biomarker.

METHODS: In this multicenter study severe TBI patients (with Glasgow Coma Scale<9) with an Injury Severity Score in non-cranial item<9 were included. Serum sCD40L concentrations at days 1, 4 and 8 of TBI were determined. We performed receiver operating characteristic analyses to determine the capacity of 30-day TBI mortality prediction by serum sCD40L levels at day 1, 4 and 8 of TBI.

RESULTS: We found that non-surviving (n=34) patients in comparison to surviving (n=90) had higher sCD40L levels on day 1 (p<0.001), 4 (p=0.004), and 8 (p<0.001) of TBI. We also found that the areas under curve of serum sCD40L concentrations at days 1, 4, and 8 of TBI to 30-day mortality prediction were 82% (p<0.001), 72% (p=0.01) and 83% (p<0.001) respectively.

CONCLUSIONS: The existence of higher serum sCD40L levels during the first week of TBI in non-surviving than in surviving patients, and that serum sCD40L levels during the first week of TBI could be used as a mortality predictor biomarker are the new findings of our study.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

brain trauma; injury; mortality; patients; sCD40L