Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients.
BACKGROUND
Oxidative stress is said to strongly influence the neurological recovery of patients following a severe head injury. Estimation of the markers of oxidative stress in the blood of such patients can hence aid in predicting the prognosis of head injury.


METHODS
Erythrocyte thiobarbituric acid-reactive substances (TBARS) and plasma ceruloplasmin (CP) levels were estimated in 24 severe head-injury patients on days 1, 7 and 21 of the post-traumatic period and compared with levels in 25 healthy age- and sex-matched controls. These parameters reflecting oxidative stress status were related to the Glasgow Coma Scale (GCS) scores of patients noted at the same time points of the study period.


RESULTS
Lipid peroxidation as indicated by increased levels of erythrocyte TBARS remained significantly elevated in severe head injury patients compared to controls on day 1 (p<0.001), day 7 (p<0.001) and 21 (p<0.001) of the post-traumatic period. Plasma CP levels remained significantly elevated (p<0.001) at these three time points compared to controls. The significant decrease in lipid peroxidation products (p<0.01) and significant increase in CP levels (p<0.001) on day 21 compared to day 1 in head injury patients correlated well with the significant improvement in GCS scores of patients on day 21 compared to day 1 (p<0.05).


CONCLUSIONS
The above results could account for the adaptation of the study patients to severe oxidative stress, as evidenced by their clinical recovery trend during the study period.
Nayak
Chandrika
C
Department of Biochemistry, Melaka Manipal Medical College (Manipal Campus), Manipal, India. chandrikadinesh@yahoo.com
Nayak
Dinesh
D
Raja
Annaswamy
A
Rao
Anjali
A
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002570:Ceruloplasmin / Q000032:analysis; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D004912:Erythrocytes / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011379:Prognosis; D012720:Severity of Illness Index; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D013997:Time Factors
D015415:Biomarkers; D017392:Thiobarbituric Acid Reactive Substances; D002570:Ceruloplasmin