Prognostic value of serum TSP-1,GFAP and local cerebral oxygen saturation on prognosis of brain function in patients with severe traumatic brain injury
Zhao Songhui
Li Biao
Yue Saichao
Miao Wang
Abstract：Objective To investigate the predictive value of serum thrombospondin-1(TSP-1),glial fibrinous acidic protein(GFAP),and local cerebral oxygen saturation(rScO2)on the prognosis in patients with severe traumatic brain injury(sTBI).Methods A total of 112 patients with sTBI were selected,and prognosis was divided into poor prognosis group(GOS score≤3 points)and good prognosis group(GOS score>3 points)according to Glasgow outcome scale(GOS)after 3 months.The clinical data,TSP-1,GFAP and rScO2 of the two groups were compared,and the relationship between serum TSP-1,GFAP and rScO2 and brain function prognosis of sTBI patients was analyzed,and the predictive value of serum TSP-1,GFAP and rScO2 on brain function prognosis was evaluated.The mortality of patients with different levels of TSP-1,GFAP and rScO2 was compared,and the effects of serum TSP-1,GFAP and rScO2 on the risk of death in sTBI patients were analyzed.Results Among 112 sTBI patients,58 cases(51.79%)had poor prognosis of brain function,all of which were included in the poor prognosis group,and 54 cases(48.21%)were included in the good prognosis group.The number of hematoma,acute physiology and chronic health status score Ⅱ(APACHEⅡ)and the proportion of cerebral hernia in the poor prognosis group were higher than those in the good prognosis group,and the score of Glasgow Coma score(GCS)was lower than that in the good prognosis group(P<0.05).Serum TSP-1 and GFAP in poor prognosis group were higher than those in good prognosis group,and rScO2 was lower than those in good prognosis group(P<0.05).Serum TSP-1,GFAP and rScO2 were independent factors influencing the prognosis of brain function in sTBI patients(P<0.05).The AUC values of serum TSP-1,GFAP and rScO2 in predicting the prognosis of brain function were 0.771,0.778 and 0.795,respectively.The AUC values of serum TSP-1,GFAP and RSCO2 were the largest(0.930),and the best sensitivity and specificity were 82.76%and 87.04%,respectively.The fatality rate of serum TSP-1 and GFAP in high level subgroup was significantly higher than that in low level subgroup,and that in rScO2 high level subgroup was lower than that in low level subgroup(P<0.05).When serum TSP-1,GFAP and rScO2 were at high levels,the mortality risk of sTBI patients was 4.667(1.419-15.350)times,3.250(1.129-9.359)times and 0.133(0.032-0.556)times of low levels,respectively.Conclusion Serum TSP-1 and GFAP increased and rScO2 decreased in patients with sTBI.Detection of their levels is helpful to predict poor prognosis of brain function,evaluate the risk of death,and provide reference for clinical diagnosis and treatment.
Keywords：traumatic brain injuryseverecerebral function prognosis distensionthrombospondin-1local cerebral oxygen saturationglial fibrillary acidic protein
Publication Date：2023-12-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 5-10 )