ERLab, Emergency Medicine Research Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLLEIDA, Avda. Rovira Roure 80, 25198, Lleida, Spain.
Faculty of Medicine, University of Lleida, Avda. Rovira Roure 80, 25198, Lleida, Spain.
Sci Rep. 2023 Nov 16;13(1):20057. doi: 10.1038/s41598-023-47267-6.
We aimed to find out which are the most frequent complications for patients who suffer a traumatic brain injury (TBI) and its relation with brain biomarker levels. We conducted a hospital cohort study with patients who attended the Hospital Emergency Department between 1 June 2018 and 31 December 2020. Different variables were collected such as biomarkers levels after 6 h and 12 h of TBI (S100, NSE, UCHL1 and GFAP), clinical and sociodemographic variables, complementary tests, and complications 48 h and 7 days after TBI. Qualitative variables were analysed with Pearson's chi-square test, and quantitative variables with the Mann-Whitney U test. A multivariate logistic regression model for the existence of complications one week after discharge was performed to assess the discriminatory capacity of the clinical variables. A total of 51 controls and 540 patients were included in this study. In the TBI group, the mean age was 83 years, and 53.9% of the patients were male. Complications at seven days were associated with the severity of TBI (p < 0.05) and the number of platelets (p = 0.016). All biomarkers except GFAP showed significant differences in their distribution of values according to gender, with significantly higher values of the three biomarkers for women with respect to men. Patients with complications presented significantly higher S100 values (p < 0.05). The patient's baseline status, the severity of the TBI and the S100 levels can be very important elements in determining whether a patient may develop complications in the few hours after TBI.
我们旨在找出创伤性脑损伤(TBI)患者最常见的并发症及其与脑生物标志物水平的关系。我们进行了一项医院队列研究,纳入了 2018 年 6 月 1 日至 2020 年 12 月 31 日期间在医院急诊科就诊的患者。收集了不同的变量,如 TBI 后 6 小时和 12 小时的生物标志物水平(S100、NSE、UCHL1 和 GFAP)、临床和社会人口统计学变量、补充检查以及 TBI 后 48 小时和 7 天的并发症。定性变量采用 Pearson 卡方检验分析,定量变量采用 Mann-Whitney U 检验分析。对出院后一周存在并发症的患者进行了多变量逻辑回归模型分析,以评估临床变量的鉴别能力。本研究共纳入 51 例对照组和 540 例患者。在 TBI 组中,患者的平均年龄为 83 岁,53.9%的患者为男性。7 天的并发症与 TBI 的严重程度(p<0.05)和血小板数量(p=0.016)相关。除 GFAP 外,所有生物标志物的分布值根据性别均有显著差异,女性的三种生物标志物值明显高于男性。有并发症的患者 S100 值明显升高(p<0.05)。患者的基线状态、TBI 的严重程度和 S100 水平可能是决定患者在 TBI 后数小时内是否会发生并发症的重要因素。