Hospital mortality of patients with severe traumatic brain injury is associated with serum PTX3 levels.
BACKGROUND
Traumatic brain injury (TBI) is a worldwide cause of morbidity and mortality. Pentraxin 3 (PTX3) is a humoral component of the innate immune system which has been studied as a marker of inflammatory, infections or cardiovascular pathologies. To investigate the association between serum levels of PTX3 and the hospital mortality of patients with severe TBI.


METHODS
The independent association between serum PTX3 levels after severe TBI (Glasgow Coma Scale, GCS ≤ 8) and hospital mortality was analyzed in a prospective study of 83 consecutive patients by a multiple logistic regression analysis. The leukocyte count in the same sample was analyzed as another marker of inflammatory response.


RESULTS
The mean age of patients was 35 years and 85% were male. Serum PTX3 levels were determined 18.0 (SD ± 17.0) h after TBI. Patients who died showed a mean serum PTX3 level of 9.95 μg/ml (SD ± 6.42) in comparison to 5.46 μg/ml (SD ± 4.87) of the survivor group (P = 0.007). Elevated serum PTX3 levels remain significantly associated with mortality (P = 0.04) in the subset of patients with isolated TBI (n = 34). There were no differences in the leukocytes count measured in the same blood sample used for PTX3 determination in survivors and non-survivors (P = 0.56). The final multiple logistic regression model including age, pupillary examination, GCS, associated trauma, and PTX3 levels shows that serum levels of PTX3 which were higher than 10 μg/ml were independently associated with the patients mortality (adjusted OR 3.06, CI 95% 1.03-9.15, P = 0.04).


CONCLUSIONS
Serum PTX3 levels after severe TBI are independently associated with higher hospital mortality and may be a useful marker of TBI and its prognosis.
Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
Jackson da Silva
Jda S
Gullo
Melina Moré
MM
Bertotti
Cláudia Carvalho Pestana
CC
Silva
Marcelo
M
Schwarzbold
Alexandre Paim
AP
Diaz
Flávia Mahatma Schneider
FM
Soares
Fernando Cini
FC
Freitas
Jean
J
Nunes
José Tadeu
JT
Pinheiro
Edelton Flavio
EF
Morato
Rui Daniel
RD
Prediger
Marcelo Neves
MN
Linhares
Roger
R
Walz
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001930:Brain Injuries / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D055815:Young Adult; D000099153:Pentraxins
D015415:Biomarkers; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins