The evaluation value of serum cholinesterase combined with GCS score in predicting the prognosis of patients with severe closed traumatic brain injury

Ma Yuxia; Tian Jun; Wang Jiaxing; Wang Shousen; Peng Huiping

doi:10.11850/j.issn.1009-122X.2024.04.002

Abstract：Objective To investigate the predictive value of admission serum cholinesterase(ChE)combined with Glasgow coma scale(GCS)score for 28-d hospital prognosis of patients with severe closed traumatic brain injury.Methods The clinical data of 87 patients with severe closed traumatic brain injury were retrospectively analyzed.The 87 patients were divided into survival group(64 cases)and death group(23 cases)according to the 28-d hospital survival.The baseline data,GCS score,ChE,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score were compared between the two groups.Multivariate logistic regression was used to analyze the factors affecting the 28-d hospital prognosis of patients with severe closed traumatic brain injury.A receiver operating characteristic(ROC)curve was drawn to acquire the optimal cut-off value,and the value of ChE combined with GCS score in evaluating the 28-d hospital prognosis of patients with severe closed traumatic brain injury was analyzed.Results The level of ChE,GCS score and hemoglobin in survival group were significantly higher than those in death group,while blood glucose,D-dimer,prothrombin time and APACHE Ⅱ score were significantly lower than those in death group(all P<0.05).Multivariate Logistic regression analysis showed that ChE,GCS score and APACHE Ⅱ score were the influencing factors of death in patients with severe closed traumatic brain injury within 28 days(all P<0.05).The ROC curve showed that the area under the curve(AUC)of the combined serum ChE and GCS score to predict the prognosis of patients with severe closed traumatic brain injury AUC was larger than that of ChE and GCS score alone.Conclusions Both ChE and GCS scores at admission have predictive value for the prognosis of patients with severe closed traumatic brain injury,and their combined value is higher.