τ Proteins in Serum Predict Outcome After Severe Traumatic Brain Injury

• Published in: The Journal of surgical research Vol. 160; no. 2; pp. 302 - 307
• Main Authors: Liliang, Po-Chou, Liang, Cheng-Loong, Weng, Hui-Ching, Lu, Kang, Wang, Kuo-Wei, Chen, Han-Jung, Chuang, Jiin-Haur
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.05.2010; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; Biomarkers - blood; Brain Injuries - blood; Brain Injuries - diagnosis; ELISA; Enzyme-Linked Immunosorbent Assay; Female; General aspects; Glasgow Coma Scale; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Logistic Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Organic mental disorders. Neuropsychology; outcome; Patient Selection; Predictive Value of Tests; Prognosis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; ROC Curve; Sensitivity and Specificity; Surgery; tau protein; tau Proteins - blood; Trauma Severity Indices; Traumas. Diseases due to physical agents; traumatic brain injury; Young Adult; traumatic brain injury; tau protein; outcome; ELISA; Nervous system diseases; Prognosis; Prediction; Enzyme immunoassay; Medicine; Treatment; Tau protein; Surgery; Evolution; Serum; Head trauma; Predictive factor; Severe; ELISA assay
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2008.12.022

The identification of reliable outcome predictors after traumatic brain injury (TBI) is crucial. The objective of our study was to investigate the role of τ protein as a serum marker of TBI. Thirty-four patients with severe TBI (Glasgow Coma Scale [GCS] score at admission ≤ 8) were considered. The τ protein level in the blood samples obtained at the time of admission was measured. The outcome was assessed by using the Glasgow Outcome Scale (GOS) at 6 mo post-injury. Demographic, clinical, and laboratory variables were analyzed to study their effect on the outcome. τ Protein levels were higher in the poor outcome group (436.2 ± 473.6 pg/mL) than in the good outcome group (51.6 ± 81.5 pg/mL) (P < 0.0001). Univariate analyses demonstrated that poor outcome was significantly associated with a poor GCS score (P = 0.001), higher serum τ protein levels (P < 0.001), abnormal pupil light reflex (P = 0.013), and basal cistern compression on computed tomogram (CT) (P = 0.026). Multivariate analyses revealed that a poor GCS score (P = 0.049) and higher serum τ protein levels (P = 0.043) were independent prognostic factors for poor outcome. The receiver-operating characteristic (ROC) curve demonstrated that a τ protein level ≥ 114.5 pg/mL yielded 88% sensitivity and 94% specificity for predicting a poor outcome. These results suggest that in addition to GCS; serum τ protein levels may serve as indicators for the prediction of outcome following severe TBI. However; it should be viewed with caution because of the small sample size and wide standard deviations.