Biomarkers/OutcomeDecreased plasma gelsolin is associated with 1-year outcome in patients with traumatic brain injury☆,☆☆
Introduction
Plasma gelsolin is the extracellular isoform of a ubiquitous cytoplasmic actin-binding protein, gelsolin, which mediates cell shape changes and motility [1]. Plasma gelsolin is associated with the severity and outcome of critical illness, and therefore, has been proposed as a prognostic marker in acute illness [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]. Recently, it has been reported that plasma gelsolin levels were also decreased in the patients with traumatic brain injury (TBI) [12] and ischemic stroke [13]; in these groups of patients, low gelsolin levels were highly predictive for 1-month mortality. Thus, the present study aimed to investigate the usefulness of gelsolin as a predictor of 1-year functional outcome and mortality in TBI.
Section snippets
Study population
From April 2008 to July 2010, all isolated head trauma patients with a postresuscitation Glasgow Coma Scale (GCS) score of 8 or less were initially assessed. Exclusion criteria were younger than 18 years, admission time greater than 6hours, previous head trauma, neurological disease including ischemic or hemorrhagic stroke, use of antiplatelet or anticoagulant medication, and presence of other previous systemic diseases including uremia, liver cirrhosis, malignancy, chronic heart or lung
Patient characteristics
During the study period, 138 patients with an isolated head trauma diagnosis were admitted to Department of Neurosurgery, the Affiliated Taizhou Municipal Hospital, Taizhou University. Of these, 24 were excluded for the following reasons: younger than 18 years (n = 3), admission time longer than 6 hours (n = 5), previous head trauma (n = 2), previous ischemic or hemorrhagic stroke (n = 3), use of antiplatelet or anticoagulant medication (n = 4), presence of other systemic diseases (n = 7), or
Discussion
In this post hoc analysis of prospective collected data, we demonstrated that plasma gelsolin levels on admission in the patients were significantly lower than those in healthy controls, and in patients who had poor functional outcome or died in a year, the gelsolin levels on admission were significantly lower compared with levels in survivors or those with good functional outcome. In multivariate logistic regression models of predictors of death and poor functional outcome, the gelsolin levels
Conclusions
In this study, decreased plasma gelsolin levels are association with 1-year functional outcome and mortality after TBI.
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Cited by (0)
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Competing interests: None.
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Institution at which the work was performed: Affiliated Taizhou Municipal Hospital, Taizhou University.