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BMC Neurology
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Research article

Serum caspase-3 levels and mortality are associated in patients with severe traumatic brain injury

Authors: Leonardo Lorente, María M. Martín, Mónica Argueso, Luis Ramos, Jordi Solé-Violán, Marta Riaño-Ruiz, Alejandro Jiménez, Juan M. Borreguero-León

Published in: BMC Neurology | Issue 1/2015

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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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Metadata
Title
Serum caspase-3 levels and mortality are associated in patients with severe traumatic brain injury
Authors
Leonardo Lorente
María M. Martín
Mónica Argueso
Luis Ramos
Jordi Solé-Violán
Marta Riaño-Ruiz
Alejandro Jiménez
Juan M. Borreguero-León
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0485-z

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