Research Reports - Serum Adhesion Molecules, Outcome and Neuro-psychological Function in Acute Traumatic Brain Injury Patients

Clin Chim Acta. 2013 Apr 30

Wang HC, Wang PM, Lin YJ, Kwan AL, Lin WC, Tsai NW, Cheng BC, Chang WN, Su BY, Kung CT, Lu CH

BACKGROUND: Serum concentrations of adhesion molecules may be associated with
secondary brain injury after acute traumatic brain injury (TBI). METHODS: Blood
samples of 68 patients admitted within 24 h after TBI were obtained on admission
and on Days 4 and 7 after TBI. Patients received neuro-psychological testing on
discharge and at 3 months after TBI. RESULTS: Compared to controls, patients with
acute TBI had markedly increased sICAM-1 and sVCAM-1 on presentation (p=0.002 and
p=0.021, respectively), but markedly decreased sL-selectin and sE-selectin
(p=0.009 and p≤0.001, respectively). Outcome was assessed upon discharge using
the Glasgow Outcome Scale (GOS). Good outcome was defined as GOS ≥4 and poor
outcome as GOS ≤3. Motor deficits on admission (p≤0.001), Glasgow Coma Scale
score on admission (p=0.002), Injury Severity Score on admission (p=0.009),
neuro-surgical intervention (p=0.004), post-traumatic seizure (p=0.04), and
sVCAM-1 level on admission (p=0.033) were significant risk factors of outcome. A
sVCAM-1 cut-off value of 752.5 ng/ml on admission had 80.0% sensitivity and 68.1%
specificity for predicting outcome. CONCLUSION: Serum adhesion molecules are not
specific for predicting outcome in patients with TBI. However, higher mean levels
of these molecules on admission may imply more severe inflammatory response
causing secondary brain injury and worse neuro-psychological function. These
molecules may be added as evaluation markers in clinical practice.

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