Plasma epinephrine as a prognostic marker in traumatic brain injury

Abstract

Background Traumatic brain injury is an international health problem with high morbidity and mortality. It is associated with catecholamine release (catecholamine surge).Objective The purpose of the work was to study plasma epinephrine as a prognostic marker in traumatic brain injury.Patients and methods The authors enrolled 60 adult persons of both sexes [30 patients with diagnosis of isolated traumatic brain injury with Glasgow coma score (GCS) ≤11 and 30 volunteers as a control group]. Plasma epinephrine levels were measured on admission and after 24 h. Then the patients were classified into two groups at the end of the study (3 months) according to the GOS: group I (favorable outcome; GOS IV, V) which included 11 (36.6%) patients and group II (unfavorable outcome; GOS I, II, III) which included 19 (63.3%) patients.Results Receiver operating characteristic curves were used to describe the prognostic value of plasma epinephrine on admission and after 24 h to predict unfavorable outcome and mortality. Higher levels of epinephrine on admission were associated with a higher rate of unfavorable outcome [areas under the curve (AUC)=0.921, confidence interval (CI): 0.828–1.014, P<0.001] and mortality (AUC=0.855, CI: 0.707–1.003, P=0.003). Also, higher levels of epinephrine after 24 h were associated with a higher rate of unfavorable outcome (AUC=0.971, CI: 0.912–1.030, P<0.001) and mortality (AUC=0.884, CI: 0.752–1.02, P=0.002).Conclusion Plasma epinephrine could be used as a prognostic marker in traumatic brain injury.