Serum Caspase-3 Levels and Mortality Are Associated in Patients with Severe Traumatic Brain Injury

Overview

Journal BMC Neurol

Publisher Biomed Central

Specialty Neurology

Date 2015 Nov 8

PMID 26545730

Citations 18

Authors

Leonardo Lorente

Maria M Martin

Monica Argueso

Luis Ramos

Jordi Sole-Violan

Marta Riano-Ruiz

Alejandro Jimenez

Juan M Borreguero-Leon

Affiliations

Soon will be listed here.

Abstract

Background: Different apoptosis pathways activate caspase-3. In a study involving 27 patients with traumatic brain injury (TBI), higher caspase-3 levels were found in contusion brain tissue resected from non-survivors than from survivors. The objective of this study was to determine whether there is an association in TBI patients between serum caspase-3 levels (thus using an easier, quicker, less expensive and less invasive procedure) and mortality, in a larger series of patients.

Methods: We carried out a prospective, observational and multicenter study in six Spanish Hospital Intensive Care Units including 112 patients with severe TBI. All had Glasgow Coma Scale (GCS) scores lower than 9. Patients with an Injury Severity Score (ISS) in non-cranial aspects higher than 9 were excluded. Blood samples were collected on day 1 of TBI to measure serum caspas-3 levels. The endpoint was 30-day mortality.

Results: We found that non-surviving patients (n = 31) showed higher (p = 0.003) serum caspase-3 levels compared to survivors (n = 81). Kaplan-Meier survival analysis showed a higher risk of death in TBI patients with serum caspase-3 levels >0.20 ng/mL than in patients with lower concentrations (Hazard Ratio = 3.15; 95% CI = 1.40 to 7.08; P < 0.001). Multiple logistic regression analysis showed that serum caspase-3 levels > 0.20 ng/mL were associated with mortality at 30 days in TBI patients controlling for Marshall CT classification, age and GCS (Odds ratio = 7.99; 95% CI = 2.116 to 36.744; P = 0.001).

Conclusions: The association between serum caspase-3 levels and mortality in TBI patients was the major novel finding of our study.

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