Hospital Mortality of Patients with Severe Traumatic Brain Injury is Associated with Serum PTX3 Levels

• DOI: 10.1007/s12028-010-9462-y
• Publication Date: 2010-10-22T15:31:53Z
• Authors: Jackson da Silva ...; Melina Moré Bertotti; Cláudia Carvalho ...; Marcelo Schwarzbold; Alexandre Paim Diaz; Flávia Mahatma Sc...; Fernando Cini Fre...; Jean Nunes; José Tadeu Pinheiro; Edelton Flavio Mo...; Rui Daniel Prediger; Marcelo Neves Lin...; Roger Walz
• Keywords: Adult; Male; Adolescent; Middle Aged; Prognosis; 3. Good health; Leukocyte Count; Serum Amyloid P-Component; Young Adult; 03 medical and health sciences; C-Reactive Protein; Logistic Models; 0302 clinical medicine; Brain Injuries; Humans; Female; Glasgow Coma Scale; Hospital Mortality; Biomarkers

Traumatic brain injury (TBI) is a worldwide cause of morbidity and mortality. Pentraxin 3 (PTX3) is a humoral component of the innate immune system which has been studied as a marker of inflammatory, infections or cardiovascular pathologies. To investigate the association between serum levels of PTX3 and the hospital mortality of patients with severe TBI.The independent association between serum PTX3 levels after severe TBI (Glasgow Coma Scale, GCS ≤ 8) and hospital mortality was analyzed in a prospective study of 83 consecutive patients by a multiple logistic regression analysis. The leukocyte count in the same sample was analyzed as another marker of inflammatory response.The mean age of patients was 35 years and 85% were male. Serum PTX3 levels were determined 18.0 (SD ± 17.0) h after TBI. Patients who died showed a mean serum PTX3 level of 9.95 μg/ml (SD ± 6.42) in comparison to 5.46 μg/ml (SD ± 4.87) of the survivor group (P = 0.007). Elevated serum PTX3 levels remain significantly associated with mortality (P = 0.04) in the subset of patients with isolated TBI (n = 34). There were no differences in the leukocytes count measured in the same blood sample used for PTX3 determination in survivors and non-survivors (P = 0.56). The final multiple logistic regression model including age, pupillary examination, GCS, associated trauma, and PTX3 levels shows that serum levels of PTX3 which were higher than 10 μg/ml were independently associated with the patients mortality (adjusted OR 3.06, CI 95% 1.03-9.15, P = 0.04).Serum PTX3 levels after severe TBI are independently associated with higher hospital mortality and may be a useful marker of TBI and its prognosis.