title: Change of serum levels of thioredoxin in patients with severe traumatic brain injury.
abstract: BACKGROUND
  Thioredoxin (TRX), a potent anti-oxidant, is released during inflammation and oxidative stress. The purpose of this study was to establish the relationship between serum TRX concentrations and trauma severity and outcome in severe traumatic brain injury (STBI).
  
  
  METHODS
  We determined serum TRX concentrations in 112 patients and 112 controls. Multivariate analyses were performed to analyze the predictive factors of 1-week mortality, 6-month mortality and 6-month unfavorable outcome. The predictive values were investigated under receiver operating characteristic curves.
  
  
  RESULTS
  Serum TRX concentrations were markedly higher in patients than in controls (19.1±7.8ng/ml vs. 8.0±2.3ng/ml, P<0.001). There was a significant negative association between serum TRX concentrations and Glasgow coma scale (GCS) scores (r=-0.543, P<0.001). Increased TRX was identified as an independent prognostic marker of 1-week mortality [Odds ratio (OR), 1.220; 95% confidence interval (CI), 1.101-1.367; P<0.001], 6-month mortality (OR, 1.201; 95% CI, 1.097-1.324; P<0.001) and 6-month unfavorable outcome (OR, 1.189; 95% CI, 1.090-1.311; P<0.001). TRX concentrations improved area under curve of GCS scores for 6-month unfavorable outcome, but not for 1-week mortality and 6-month mortality.
  
  
  CONCLUSIONS
  Increased serum TRX concentration, associated highly with trauma severity and poor outcome, might be a novel prognostic marker in patients with STBI.
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. Electronic address: pshenpan@sina.com.
authors.forename: De-Sheng
authors.initials: DS
authors.lastname: Pan
authors.affiliation: Department of Neurosurgery, The People's Hospital of Beilun District, Beilun Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1288 Lushan East Road, Beilun District, Ningbo 315800, China.
authors.forename: Hai-Wei
authors.initials: HW
authors.lastname: Le
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Hassan
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Jiang-Biao
authors.initials: JB
authors.lastname: Gong
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D018384:Oxidative Stress; D011379:Prognosis; D013879:Thioredoxins / Q000097:blood*
chemical_list: D013879:Thioredoxins
keywords: Function outcome; Mortality; Severity; Thioredoxin; Traumatic brain injury