Serum cleaved tau protein levels and clinical outcome in adult patients with closed head injury
Serum cleaved tau protein levels and clinical outcome in adult patients with closed head injury
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DOI：
10.1067/mem.2002.121214
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发表时间：
2002-03-01
影响因子：
6.2
通讯作者：
Zemlan, FP
中科院分区：
文献类型：
--
作者：
Shaw, GJ;Jauch, EC;Zemlan, FP
研究目的：颅内损伤（ICI）与高死亡率和发病率相关。不幸的是，在急诊科，脑缺血的诊断和危险分层的工具是有限的。我们确定了存在或不存在可检测到的切割血清tau蛋白（tau（C）），ICI，并在出院的结果在成人闭合性脑损伤（CHI）之间的关系：这是一个前瞻性的试点研究的成人患者CHI提出的艾德的城市一级创伤中心。在CHI后10小时内就诊并接受头部计算机断层扫描（CT）的患者符合条件。就诊时采集血液样本并测量tau（C）水平。记录初始格拉斯哥昏迷量表评分和人口统计学信息。一个图表进行审查，以确定结果和最终读数的初始头部CT scain.Results：患者被二分为2组之一，ICI（n = 17）和孤立的颅骨骨折或无CT异常（NICI）（n = 11）。两组在人口构成、损伤机制和共存损伤方面相似。tau（C）水平大于0与初次头部CT扫描中ICI的机会增加相关（比值比11.25; 95%置信区间[CI] 1.17至108.4），且不良结局（定义为住院期间死亡或出院时转至疗养院）的可能性更大结论：tau（C）水平大于0与CHI患者颅内损伤和预后不良的可能性较大相关。
Study objective: Intracranial injuries (ICI) are associated with high mortality and morbidity. Unfortunately, tools for diagnosis and risk stratification of ICIs are limited in the emergency department setting. We determine the relationship between the presence or absence of a detectable cleaved serum tau protein (tau(C)), ICI, and outcome at hospital discharge in adults with closed head injuries (CHI).Methods: This was a prospective pilot study of adult patients with CHI presenting to the ED of an urban Level I trauma center. Patients presenting within 10 hours of a CHI who underwent a head computed tomographic (CT) scan were eligible. A blood sample was collected at presentation and the tau(C) level was measured. Initial Glasgow Coma Scale scores and demographic information were recorded. A chart review was performed to determine outcome and final readings on the initial head CT scan.Results: Patients were dichotomized to 1 of 2 groups, those with an ICI (n = 17) and those with an isolated skull fracture or no CT abnormality (NICI) (n = 11). The 2 groups were similar in regard to demographic composition, mechanism of injury, and coexisting injuries. A tau(C) level of more than 0 was associated with an increased chance of an ICI on the initial head CT scan (odds ratio 11.25; 95% confidence interval [CI] 1.17 to 108.4) and a greater chance of poor outcome, defined as death while in hospital or transfer to a nursing home at hospital discharge (odds ratio 8.17; 95% Cl 1.42 to 47).Conclusion: A tau(C) level of more than 0 is associated with a greater chance of intracranial injury and poor outcome in patients with CHI.