创伤性脑损伤合并颅内损伤后血清维生素E水平与功能预后：一项多中心前瞻性研究。
Serum vitamin E level and functional prognosis after traumatic brain injury with intracranial injury: A multicenter prospective study.
作者信息
Park Gwan Jin, Ro Young Sun, Yoon Hanna, Lee Stephen Gyung Won, Jung Eujene, Moon Sung Bae, Kim Sang Chul, Shin Sang Do
机构信息
Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
出版信息
Front Neurol. 2022 Oct 19;13:1008717. doi: 10.3389/fneur.2022.1008717. eCollection 2022.
BACKGROUND
Traumatic brain injury (TBI) is a major public health problem with high mortality and disability. Vitamin E, one of the antioxidants for treatment of TBI, has not been sufficiently evaluated for predicting prognosis of TBI. This study aimed to evaluate the prognostic value of vitamin E on functional outcomes of TBI patients with intracranial injury.
METHODS
A multi-center prospective cohort study was conducted in five university hospitals between 2018 and 2020. Adult TBI patients who visited the emergency department (ED) with intracranial hemorrhage or diffuse axonal injury confirmed by radiological examination were eligible. Serum vitamin E levels (mg/dL) were categorized into 4 groups: low (0.0-5.4), low-normal (5.5-10.9), high-normal (11.0-16.9), and high (17.0-). Study outcomes were set as 1- and 6-month disability (Glasgow outcome scale (GOS) 1-4). Multilevel logistic regression analysis was conducted to calculate the adjusted odds ratios (AORs) of vitamin E for related outcomes.
RESULTS
Among 550 eligible TBI patients with intracranial injury, the median (IQR) of serum vitamin E was 10.0 (8.0-12.3) mg/dL; 204/550 (37.1%) had 1-month disability and 197/544 (36.1%) had 6-month disability of GOS 1-4. Compared with the high-normal group, the odds of 1-month disability and 6-month disability increased in the low and low-normal group (AORs (95% CIs): 3.66 (1.62-8.27) and 2.60 (1.15-5.85) for the low group and 1.63 (1.08-2.48) and 1.60 (1.04-2.43) for the low-normal group, respectively).
CONCLUSION
Low serum vitamin E level was associated with poor prognosis at 1 and 6 months after TBI with intracranial injury.
背景
创伤性脑损伤（TBI）是一个具有高死亡率和高致残率的重大公共卫生问题。维生素E作为治疗TBI的抗氧化剂之一，尚未对其预测TBI预后的价值进行充分评估。本研究旨在评估维生素E对颅内损伤的TBI患者功能结局的预后价值。
方法
2018年至2020年期间在五所大学医院进行了一项多中心前瞻性队列研究。符合条件的为因颅内出血或经影像学检查确诊为弥漫性轴索损伤而就诊于急诊科（ED）的成年TBI患者。血清维生素E水平（mg/dL）分为4组：低水平（0.0 - 5.4）、低正常水平（5.5 - 10.9）、高正常水平（11.0 - 16.9）和高水平（17.0及以上）。研究结局设定为1个月和6个月时的残疾情况（格拉斯哥预后评分（GOS）为1 - 4）。进行多水平逻辑回归分析以计算维生素E相关结局的调整比值比（AOR）。
结果
在550例符合条件的颅内损伤TBI患者中，血清维生素E的中位数（IQR）为10.0（8.0 - 12.3）mg/dL；204/550（37.1%）的患者在1个月时出现残疾，197/544（36.1%）的患者在6个月时出现GOS 1 - 4级残疾。与高正常水平组相比，低水平组和低正常水平组1个月和6个月时残疾的几率增加（低水平组的AOR（95%CI）：3.66（1.62 - 8.27）和2.60（1.15 - 5.85），低正常水平组分别为1.63（1.08 - 2.48）和1.60（1.04 - 2.43））。
结论
血清维生素E水平低与颅内损伤的TBI患者在伤后1个月和6个月时预后不良相关。
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