Serum melatonin levels in predicting mortality in patients with severe traumatic brain injury - 17/12/21
, María M. Martín b, Candelaria Ruiz b, Pedro Abreu-González c, Luis Ramos-Gómez d, Mónica Argueso e, Jordi Sole-Violan f, Juan J. Cáceres g, Alejandro Jiménez hBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | Serum melatonin levels during the first week were higher in non-surviving patients. |
• | Serum melatonin levels during the first week could predict 30-day mortality. |
Abstract |
Purpose |
A secondary brain injury could appear after traumatic brain injury (TBI) due to neuroinflammation, oxidation and apoptosis. Higher levels of serum melatonin have been found on admission for TBI in non-surviving than in surviving patients. Thus, the objective of this study was to know serum melatonin levels during the first week of TBI in surviving and non-surviving patients, and to know if serum melatonin levels during the first week of TBI can be used to predict mortality.
Methods |
Patients with an isolated and severe TBI were included; that is, if they scored < 10 points in non-cranial aspects of Injury Severity Score and < 9 points in the Glasgow Coma Scale. We measured serum melatonin concentrations at days 1, 4 and 8 of TBI. Thirty-day mortality was the end-point study.
Results |
Lower serum melatonin levels were found in the surviving patients (n = 90) than in the non-survivors (n = 34) on days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.02) of TBI. Serum melatonin concentrations on days 1, 4, and 8 of TBI had an area under curve (95% Confidence Interval) for the prediction of 30-day mortality of 0.85 (0.77-0.91; p < 0.001), 0.82 (0.74–0.89; p < 0.001) and 0.71 (0.61–0.79; p = 0.06) respectively.
Conclusions |
The new findings of this study were the presence of higher levels of serum melatonin on days 1, 4 and 8 of TBI in non-survivors than in survivors, and the ability to predict 30-day mortality for serum melatonin levels measured at these time points. However, more research is necessary to confirm our results.
Le texte complet de cet article est disponible en PDF.Abbreviations : APACHE II, aPTT, CPP, FIO2, GCS, ICP, ICU, INR, ISS, PaO2
Keywords : Melatonin, Traumatic brain injury, Patients, Mortality, Prognosis
Plan
Vol 40 - N° 6
Article 100966- décembre 2021 Retour au numéro
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