NSE/GCS in perioperative period on Seventh day as an independent predictor of 90-day outcome in patients with severe traumatic brain injury

Chunying  Zhu; Xiaona  Liu; Huan  Wang; Yingfu Zhang; Wei  Li

doi:10.5937/jomb0-61005

Chunying Zhu Department of Neuroscience Intensive Care Unit, The First Central Hospital of Baoding, Hebei Province, 071000, China
Xiaona Liu Department of Critical Care Medicine, Lai Shui County Hospital of Baoding,Hebei Province, 071000, China
Huan Wang Department of Neuroscience Intensive Care Unit, The First Central Hospital of Baoding, Hebei Province, 071000, China
Yingfu Zhang Endoscopic Diagnosis and Treatment Center. The First Central Hospital of Baoding, Baoding,071000, China
Wei Li Department of Neuroscience Intensive Care Unit, The First Central Hospital of Baoding, Hebei Province, 071000, China

DOI: https://doi.org/10.5937/jomb0-61005

Keywords: Neuron-specific enolase, Glasgow Coma Scale, biomarker, Prognosis, Traumatic brain injury

Abstract

Summary:

Background and Objectives: Traumatic brain injury (TBI) can lead to secondary damage that affects patient prognosis. Neuron-specific enolase (NSE) in the blood is a marker of nerve damage, while the Glasgow Coma Scale (GCS) score indicates patient consciousness. The ratio of NSE to GCS (NGR) during the perioperative period can assess the 90-day prognosis in severe TBI patients.

Methods: This study involved 63 severe TBI patients. We collected their clinical and preadmission lab data. After admission, we provided personalized comprehensive treatment, including blood tests, interleukin 6 (IL-6), NSE, blood osmotic pressure (OSM), procalcitonin (PCT), and D-dimer (DD). We evaluated GCS score on Day 7 to calculate NGR. Using logistic regression and receiver operating characteristic (ROC) curve, we analyzed Pre-admission NLR0, and NSE7, GCS7, and NGR7 on the seventh day of admission.

Results: Patients with poor 90-day outcomes were older, had longer hospital stays, and showed higher NLR0 and IL-6 levels on admission (all P < 0.05). NLR0, NSE7, GCS7 scores, and NGR7 independently predicted poor outcomes in severe TBI patients. NGR7 showed a strong Pearson r value (r = -0.702, p < 0.0001) and the highest diagnostic accuracy for 90-day prognosis [area under the curve (AUC) = 0.932; 95% CI = 0.872-0.993, with a cut-off value of 4.69, sensitivity of 86.49%, and specificity of 92.31%]. TBI patients with higher NGR on the seventh day after admission were more likely to experience unfavorable neurological outcomes.

Conclusion: NGR on the seventh day after admission significantly predicts the 90-day outcomes in severe TBI patients.

Author Biographies

Chunying Zhu, Department of Neuroscience Intensive Care Unit, The First Central Hospital of Baoding, Hebei Province, 071000, China

Chunying Zhu and Chengguang Zhao: they contributed equally to the article

Wei Li, Department of Neuroscience Intensive Care Unit, The First Central Hospital of Baoding, Hebei Province, 071000, China

First Corresponding Author：Yingfu Zhang

Second Corresponding Author：Wei Li

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