Dynamics of the neurofilament pNF-H as a predictor of mortality in children with brain injury


Authors: Žurek Jiří 1,2;  Baštáková Lenka 1;  Mihalčin Matúš 1;  Forbelská Marie 3;  Fedora Michal 1,2
Authors‘ workplace: Lékařská fakulta, Masarykova univerzita, Brno 1;  Klinika dětské anesteziologie a resuscitace, Fakultní nemocnice Brno 2;  Ústav matematiky a statistiky, Přírodovědecká fakulta, Masarykova univerzita, Brno 3
Published in: Anest. intenziv. Med., 21, 2010, č. 6, s. 331-336
Category: Intensive Care Medicine - Original Paper

Overview

Objective:
The aim of the study was to determine the importance of increased levels of a high-molecular weight form of neuro-filament subunit (pNF-H) in the serum of children with brain injury, as a predictor of mortality.

Design:
Prospective observational study.

Setting:
Department of Anaesthesiology and Intensive Care Medicine, University Hospital. Materials and methods: Total 50 children aged 0–19 years hospitalized between June 2007 and September 2009 with severe brain injury were examined. Serum samples were collected on admission and each following day for the first 6 days of hospitalization. Statistical analysis was performed using Wilcoxon test (p < 0.05). The dynamics of the protein serum levels was determined by ANOVA model and discriminatory values of pNF-H were determined by ROC analysis.

Results:
Eight (8) children died in the observation group. In these patients, compared with the survivors, we observed a significant increase in the serum values in the first 3 days, followed by a stagnation: Day 1: 310 pg/mL vs. 97.7 (p = 0.17); day 2:1307 pg/mL vs. 153 (p = 0.004); day 3: 2640 pg/mL vs. 227 (p = 0.006); day 4: 2100 pg/mL vs. 199 (p = 0.001); day 5: 847 pg/mL vs. 467 (p = 0.03); day 6: 1762 pg/mL vs. 573 (p= 0.03). The results of ROC analysis suggest that the levels of pNF-H measured from the second to the sixth day of hospitalization are a suitable predictor of mortality.

Conclusion:
A significant relation of elevated serum levels of pNF-H and mortality was found in patients after cranio-cerebral injury.

Key words:
head injury – neurofilament – biomarker – dynamics – children


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Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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