TY  - JOUR
PY  - 2019//
TI  - Non-surviving patients with severe traumatic brain injury have maintained high serum sCD40L levels
JO  - World neurosurgery
A1  - Lorente, Leonardo
A1  - Martín, María M.
A1  - González-Rivero, Agustín F.
A1  - Ramos, Luis
A1  - Argueso, Mónica
A1  - Cáceres, Juan J.
A1  - Solé-Violán, Jordi
A1  - Jiménez, Alejandro
A1  - Borreguero-León, Juan M.
A1  - García-Marín, Victor
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2019.03.179
ID  - ref1
ER  -