Value of the combination of serum AQP4 level and the ratio of GCS score to shock index in the prognosis evaluation of patients with severe traumatic brain injury
TANG Xin-hua
TANG Tao
XIAO Ying
Abstract：Objective To evaluate the prognostic value of serum aquaporin 4(AQP4)levels in conjunction with the ratio of Glasgow Coma Scale score to shock index(rSIG)for patients with severe traumatic brain injury(TBI).Methods A retrospective analysis was conducted on the clinical data of 126 patients with severe TBI admitted between January 2020 and August 2022.Prognosis was assessed at 90 days post-injury using the Glasgow Outcome Scale,where scores of 4～5 indicated a favorable outcome and scores of 1～3 indicated an unfavorable outcome.Results At 90 days post-injury,78 patients exhibited a favorable prognosis,while 48 patients had an unfavorable prognosis.The serum AQP4 level in the favorable prognosis group(36.71±6.57 ng/ml)was significantly lower than that in the unfavorable prognosis group(45.64±6.79 ng/ml;P<0.001).Additionally,the rSIG in the favorable prognosis group(10.77±2.11)was significantly higher compared to the unfavorable prognosis group(7.50±1.43;P<0.001).Multivariate logistic regression analysis revealed that elevated serum AQP4 levels(OR=1.234;95%CI 1.041～1.462;P=0.015)were an independent risk factor for an unfavorable prognosis at 90 days post-injury,whereas increased rSIG values were associated with a favorable prognosis(OR=0.132;95%CI 0.040～0.437;P=0.0001).ROC curve analysis demonstrated that serum AQP4≥41.6 ng/ml and rSIG≤9.265 had sensitivities of 74.36%and 80.77%,respectively,and specificities of 72.92%and 83.33%,for predicting an unfavorable prognosis of severe TBI.Combined prediction yielded a sensitivity of 88.46%and a specificity of 83.33%.Conclusion Serum AQP4 levels are significantly elevated,while rSIG values are significantly reduced in patients with severe TBI.The combined use of these two parameters provides a robust predictive value for identifying unfavorable outcomes in such patients.
Keywords：Severe traumatic brain injuryPrognosisSerumAquaporin 4(AQP4)Ratio of Glasgow Coma Scale score to shock index(rSIG)
Publication Date：2025-02-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 83-87 )