Clinical Value Of Serum Gelsolin In Predicting The Outcome Of Patients With Severe Traumatic Brain Injury

Purpose:To evaluate predictive value of plasma gelsolin concentration for 6-month mortality and unfavorable outcome after severe traumatic brain injury and compare its predictive value with those of Glasgow Coma Scale score on admission, and plasma neuron specific enolase, S100B, myelin basic protein and glial fibrillary acidic protein concentrations.Methods:Between June 2009 and June 2012,80 patients with severe traumatic brain injury and 80 sex and age-matched healthy individuals were recruited in the Hangzhou First People’s hospital. Plasma gelsolin, neuron specific enolase, S100B, myelin basic protein and glial fibrillary acidic protein concentrations were determined using enzyme-linked immunosorbent assay. Predictive values of Glasgow Coma Scale score on admission, and other biomarkers for 6-month mortality and unfavorable outcome were analyzed and their predictive values were compared statistically.Results:Plasma gelsolin concentration was markedly lower in the 80 patients (64.1±20.2μg/mL) than in healthy individuals (126.2±29.5μg/mL) and plasma neuron specific enolase (25.8±11.0ng/mL), S100B (448.6±120.4pg/mL), myelin basic protein (25.4±9.1μg/mL) and glial fibrillary acidic protein (16.8±4.8pg/mL) concentrations were obviously higher in patients than in healthy individuals, the healthy individuals were 3.6±1.6 ng/mL、59.2±18.3 pg/mL,3.4±1.1μg/mL and 2.4±0.6 pg/mL, respectively. Receiver operating characteristics(ROC) curve analysis showed that plasma gelsolin concentration (The area under the curve 0.816,95% CI 0.714～0.894) markedly predicted 6-month mortality and unfavorable outcome after severe traumatic brain injury. When its predictive value was compared with those of Glasgow Coma Scale score (The area under the curve 0.892,95% CI 0.803-0.951) on admission, and plasma neuron specific enolase (The area under the curve 0.832,95% CI0.732～0.906), S100B (The area under the curve 0.806,95% CI 0.703-0.886), myelin basic protein (The area under the curve 0.840,95% CI 0.741-0.912) and glial fibrillary acidic protein (The area under the curve 0.847,95% CI 0.749～0.917) concentrations, theses differences were not statistically significant.Conclusion:Determination of gelsolin in plasma may help in the prediction of long-term outcome in patients with severe traumatic brain injury with higher clinical value.