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Volume 8, Issue 5, October 2020, Page: 140-152
Clinical and Biochemical Predictors of Fatality in Traumatic Brain Injury
Kadhaya David Muballe, Department of Neurosurgery, Walter Sisulu University, Mthatha, South Africa
Sewani Constance Rusike, Department of Physiology, Walter Sisulu University, Mthatha, South Africa
Benjamin Longo-Mbenza, Department of Public Health, Walter Sisulu University, Mthatha, South Africa
Jehu Iputo, Department of Physiology, Walter Sisulu University, Mthatha, South Africa
Received: Jun. 24, 2020;       Accepted: Jul. 20, 2020;       Published: Aug. 13, 2020
DOI: 10.11648/j.js.20200805.11      View  79      Downloads  38
Abstract
Traumatic brain injury is a global health problem, it is a major cause of devastating neurological sequelae and significant mortality. The underlying physiological events in traumatic brain injury are responsible for the poor clinical outcomes seen in patients. Inflammatory and oxidative stress changes in traumatic brain injury result in the release of inflammatory biomarkers, a reduction in the endogenous anti-oxidants and dysfunction of the blood brain barrier. An understanding of the natural history of oxidative stress and inflammatory changes in traumatic brain injury can help design appropriate management protocols to reduce mortality and morbidity in these patients. Aim of the study: The aim of this study was to identify potential biomarkers that are predictive of fatality in patients with moderate to severe traumatic brain injury. Methods: This was a prospective study of patients with moderate to severe traumatic brain injury managed at the Nelson Mandela Academic Hospital during the period March 2014 - March 2016. Following admission and management, the patient demographics (sex, age) and admission Glasgow Coma Score were recorded. Oxidative stress and inflammatory biomarkers in blood and cerebrospinal fluid where sampled on day 1 to 7. On day 14 only blood was sampled for the same biomarkers. The primary outcome was the Glasgow Outcome score assessed on day 90. Due to its simplicity the Glasgow Outcome scale was used to assess clinical outcomes at day 90. Because of difficulty in regular follow up due to the vastness of our region, difficult terrain and long travel distances a 3 month follow up period was used to avoid default. Results: Of the 64-patient’s, fatality was noted in 12.5% of them. There was a significant association between fatality and the; ages of the patients, anti-oxidant levels, proinflammatory biomarkers and admission Glasgow Coma Score. Conclusion: The admission Glasgow Coma Score, low anti-oxidant levels and elevated serum interleukin-1β levels were associated with fatal outcomes.
Keywords
Traumatic Brain Injury, Age, Anti-oxidants, Glasgow Outcome Score, Interleukins, Fatality
To cite this article
Kadhaya David Muballe, Sewani Constance Rusike, Benjamin Longo-Mbenza, Jehu Iputo, Clinical and Biochemical Predictors of Fatality in Traumatic Brain Injury, Journal of Surgery. Vol. 8, No. 5, 2020, pp. 140-152. doi: 10.11648/j.js.20200805.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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