title: Serial serum leukocyte apoptosis levels as predictors of outcome in acute traumatic brain injury.
abstract: BACKGROUND
  Apoptosis associates with secondary brain injury after traumatic brain injury (TBI). This study posits that serum leukocyte apoptosis levels in acute TBI are predictive of outcome.
  
  
  METHODS
  Two hundred and twenty-nine blood samples from 88 patients after acute TBI were obtained on admission and on Days 4 and 7. Serial apoptosis levels of different leukocyte subsets were examined in 88 TBI patients and 27 control subjects.
  
  
  RESULTS
  The leukocyte apoptosis was significantly higher in TBI patients than in controls. Brief unconsciousness (P = 0.009), motor deficits (P ≤ 0.001), GCS (P ≤ 0.001), ISS (P = 0.001), WBC count (P = 0.015), late apoptosis in lymphocytes and monocytes on Day 1 (P = 0.004 and P = 0.022, resp.), subdural hemorrhage on initial brain CT (P = 0.002), neurosurgical intervention (P ≤ 0.001), and acute posttraumatic seizure (P = 0.046) were significant risk factors of outcome. Only motor deficits (P = 0.033) and late apoptosis in monocytes on Day 1 (P = 0.037) were independently associated with outcome. A cutoff value of 5.72% of late apoptosis in monocytes was associated with poor outcome in acute TBI patients.
  
  
  CONCLUSIONS
  There are varying degrees of apoptosis in patients following TBI and in healthy individuals. Such differential expression suggests that apoptosis in different leukocyte subsets plays an important role in outcome following injury.
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan ; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Wang
authors.affiliation: Division of Neurosurgery, Department of Surgery, Yuan's General Hospital, Kaohsiung 80249, Taiwan.
authors.forename: Tzu-Ming
authors.initials: TM
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan ; Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan.
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Wu-Fu
authors.initials: WF
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Jih-Tsun
authors.initials: JT
authors.lastname: Ho
authors.affiliation: Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Yu-Tsai
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan ; Departments of Neurosurgery, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
authors.forename: Aij-Lie
authors.initials: AL
authors.lastname: Kwan
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D017304:Annexin A5 / Q000378:metabolism; D017209:Apoptosis; D001930:Brain Injuries / Q000097:blood* / Q000473:pathology*; D016022:Case-Control Studies; D003609:Dactinomycin / Q000031:analogs & derivatives / Q000378:metabolism; D003710:Demography; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000378:metabolism; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017304:Annexin A5; D003609:Dactinomycin; C025942:7-aminoactinomycin D