Catecholamines as outcome markers in isolated traumatic brain injury – The COMA-TBI study

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Authors
  1. Rizoli, S.B.
  2. Jaja, B.N.R.
  3. Di Battista, A.P.
  4. Rhind, S.G.
  5. Capone Neto, A.
  6. da Costa, L.
  7. Inaba, K.
  8. da Luz, L.T.
  9. Nascimento, B.
  10. Perez, A.
  11. Baker, A.J.
  12. Leonardo, A.
Corporate Authors
Defence Research and Development Canada, Toronto Research Centre , Toronto ON (CAN)
Abstract
Background: Elevated catecholamine levels might be associated with unfavorable outcome after traumatic brain injury (TBI). We investigated the association between catecholamine levels in the first 24 h post-trauma and functional outcome in patients with isolated moderate-to-severe TBI. Methods: A cohort of 174 patients who sustained isolated blunt TBI was prospectively enrolled from three Level-1 Trauma Centers. Epinephrine (Epi) and norepinephrine (NE) concentrations were measured at admission (baseline), 6, 12 and 24 h post-injury. Outcome was assessed at 6 months by the extended Glasgow Outcome Scale (GOSE) score. Fractional polynomial plots and logistic regression models (fixed and random effects) were used to study the association between catecholamine levels and outcome. Effect size was reported as the odds ratio (OR) associated with one logarithmic change in catecholamine level. Results: At 6 months, 109 patients (62.6%) had an unfavorable outcome (GOSE 5–8 vs. 1–4), including 51 deaths (29.3%). Higher admission levels of Epi were associated with a higher risk of unfavorable outcome (OR, 2.04, 95% CI: 1.31–3.18, p = 0.002) and mortality (OR, 2.86, 95% CI: 1.62–5.01, p = 0.001). Higher admission levels of NE were associated with higher risk of unfavorable outcome (OR, 1.59, 95% CI: 1.07–2.35, p = 0.022) but not mortality (OR, 1. 45, 95% CI: 0.98–2.17, p = 0.07). There was no relationship between the changes in Epi levels over time and mortality or unfavorabl
Keywords
traumatic brain injury;catecholamines;epinephrine;norepineprhine;functional outcome
Report Number
DRDC-RDDC-2017-P017 — External Literature
Date of publication
01 Apr 2017
Number of Pages
10
DSTKIM No
CA045589
CANDIS No
806013
Format(s):
Electronic Document(PDF)

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