Trauma Scores and Neuron-Specific Enolase, Cytokine and C-Reactive Protein Levels as Predictors of Mortality in Patients with Blunt Head Trauma

• Published in: Journal of international medical research 2010-09, Vol.38 (5), p.1708-1720
• Main Authors: Sogut, O, Guloglu, C, Orak, M, Sayhan, MB, Gokdemir, MT, Ustundag, M, Akkus, Z
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biomarkers - blood; C-Reactive Protein - metabolism; Child; Child, Preschool; Female; Head Injuries, Closed - diagnosis; Head Injuries, Closed - metabolism; Head Injuries, Closed - mortality; Humans; Infant; Interleukin-6 - blood; Interleukin-8 - blood; Male; Middle Aged; Phosphopyruvate Hydratase - blood; Prognosis; Prospective Studies; Trauma Severity Indices; Tumor Necrosis Factor-alpha - blood; Turkey; Young Adult
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/147323001003800516

This study evaluated serum neuron-specific enolase (NSE), cytokine and high-sensitivity C-reactive-protein (hs-CRP) levels, along with the Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS), as predictors of mortality in the early post-traumatic period, in 100 Turkish patients with blunt head trauma. Overall patient mortality was 27%. There was a significant association between age and mortality, and mortality was negatively correlated with GCS and RTS. Head injury severity (GCS) was significantly related to NSE, hs-CRP, interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α levels. Mortality correlated positively with IL-6, IL-8, TNF-α and hs-CRP levels. NSE, hs-CRP, IL-6, IL-8 and TNF-α levels were significantly higher in non-survivors compared with survivors. GCS score ≤ 8, younger age and NSE levels were significant independent predictors of mortality. During the early post-traumatic period, NSE may be an objective alternative criterion to the GCS, in the management of patients with blunt head trauma.