Hatefi Masoud, Dastjerdi Masoud Moghadas, Ghiasi Bahareh, Rahmani Asghar
Assistant Professor, Department of Neurosurgery, Faculty of Medicine, Ilam University of Medical Science , Ilam, Iran .
Assistant Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Science , Isfahan, Iran .
J Clin Diagn Res. 2016 Dec;10(12):OC20-OC24. doi: 10.7860/JCDR/2016/21918.8993. Epub 2016 Dec 1.
The prognostic value of serum Uric Acid (UA) levels in Traumatic Brain Injury (TBI) is unclear.
To investigate the relationship between serum UA levels and prognosis of patients with TBI when in hospital and at six months after discharge.
All patients attended our emergency department during July 2014 and December 2015 and were consecutively entered into the study and among 890 evaluated candidates based on inclusion criteria we finally investigated the serum UA levels of 725 TBI patients. Computed Tomography (CT) images of the brain were obtained within the first 24 hours of hospitalization. Outcome was assessed using the Glasgow Outcome Scale (GOS) score at discharge and at six months after discharge.
Data of 725 patients (42.89% men; mean age: 54.69±12.37 years) were analyzed. Mean±Standard Deviation (SD) of Glasgow Coma Scale (GCS) scores was 4.65±1.76. Serum levels of UA, when in hospital and at six months after discharge, among those who died were lower than those who survived (in hospital: 0.126±0.026 vs. 0.243±0.942 mmol/l, p = 0.000; 6 months post-discharge: 0.130±0.044 vs. 0.286±0.069 mmol/l, p<0.001). The mean UA plasma was significantly different between deceased and alive patients according to GOS scores (p<0.001 and p=0.030, respectively). The UA levels showed a significant relationship with GCS scores and severity of brain injury assessed using the Marshall Classification Score (p=0.005).
Our results showed a strong relationship between UA levels and patients' outcomes either in hospital or at six months after discharge. Serum UA level could be considered as a valuable marker for evaluating the severity of brain injury and outcomes of TBI.
血清尿酸（UA）水平在创伤性脑损伤（TBI）中的预后价值尚不清楚。
探讨血清UA水平与TBI患者住院时及出院后6个月预后的关系。
2014年7月至2015年12月期间所有就诊于我院急诊科的患者均连续纳入本研究，在890例符合纳入标准的评估对象中，最终对725例TBI患者的血清UA水平进行了调查。在住院的前24小时内获取脑部计算机断层扫描（CT）图像。出院时及出院后6个月使用格拉斯哥预后量表（GOS）评分评估预后。
分析了725例患者的数据（男性占42.89%；平均年龄：54.69±12.37岁）。格拉斯哥昏迷量表（GCS）评分的平均值±标准差为4.65±1.76。死亡患者住院时及出院后6个月的血清UA水平低于存活患者（住院时：0.126±0.026 vs. 0.243±0.942 mmol/l，p = 0.000；出院后6个月：0.130±0.044 vs. 0.286±0.069 mmol/l，p<0.001）。根据GOS评分，死亡患者和存活患者的平均UA血浆水平有显著差异（分别为p<0.001和p = 0.030）。UA水平与GCS评分及使用马歇尔分类评分评估的脑损伤严重程度有显著关系（p = 0.005）。
我们的结果表明，UA水平与患者住院时或出院后6个月的预后有密切关系。血清UA水平可被视为评估脑损伤严重程度和TBI预后的有价值标志物。
