title: The role of cell-free DNA measured by a fluorescent test in the management of isolated traumatic head injuries.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a major cause of death and disability. In this study a new method to measure cell free DNA (CFD) for the management of TBI is tested. Our hypothesis was that CFD concentrations correlate to the magnitude of brain damage, and may predict the outcome of injured patients.
  
  
  METHODS
  Twenty eight patients with isolated head injury were enrolled. Their demographic and clinical data were recorded. CFD levels were determined in patients' sera samples by a direct fluorescence method developed in our laboratory.
  
  
  RESULTS
  Mean admission CFD values were lower in patients with mild TBI compared to severe injury (760 ± 340 ng/ml vs. 1600 ± 2100 ng/ml, p = 0.03), and in patients with complete recovery upon discharge compared to patients with disabilities (680 ± 260 ng/ml vs. 2000 ± 2300 ng/ml, p = 0.003). Patients with high CFD values had a relative risk to require surgery of 1.5 (95% CI 0.83 to 2.9) a relative risk to have impaired outcome on discharge of 2.8 (95% CI 0.75 - 10), and a longer length of stay (12 ± 13 days vs. 3.4 ± 4.8 days, p = 0.02). CFD values did not correlate with CT scan based grading.
  
  
  CONCLUSIONS
  CFD levels may be used as a marker to assess the severity of TBI and to predict the prognosis. Its use should be considered as an additional tool along with currently used methods or as a surrogate for them in limited resources environment.
authors.affiliation: Department of General Surgery, Trauma Unit, Soroka University Medical Center, 68 Wingate St,, Beer Sheva 84101, Israel. shakedg@bgu.ac.il.
authors.forename: Gad
authors.initials: G
authors.lastname: Shaked
authors.forename: Amos
authors.initials: A
authors.lastname: Douvdevani
authors.forename: Silvia
authors.initials: S
authors.lastname: Yair
authors.forename: Alexander
authors.initials: A
authors.lastname: Zlotnik
authors.forename: David
authors.initials: D
authors.lastname: Czeiger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002474:Cell-Free System / Q000378:metabolism; D004247:DNA / Q000134:cerebrospinal fluid*; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D016489:Head Injuries, Closed / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004247:DNA