High Serum Soluble Fas Ligand Levels in Non-survivor Traumatic Brain Injury Patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-01-06

AUTHORS

Leonardo Lorente, María M. Martín, Antonia Pérez-Cejas, Agustín F. González-Rivero, Luis Ramos-Gómez, Jordi Solé-Violán, Juan J. Cáceres, Judith Cabrera, Andrea Alvarez-Castillo, Carmen Ferrer-Moure, Alejandro Jiménez

ABSTRACT

PurposeSoluble Fas Ligand (sFasL) is one of the main ligands that activates the apoptosis extrinsic pathway. Higher expression of FasL in brain samples and higher cerebrospinal fluid FasL concentrations in traumatic brain injury (TBI) patients than in controls have been found. However, the potential association between blood sFasL concentrations and TBI mortality has not been reported. Therefore, the objective of this study was to determine whether that association exists.MethodsWe included patients with a severe isolated TBI, defined as < 9 points in Glasgow Coma Scale (GCS) and < 10 non-cranial aspects points in Injury Severity Score in this observational and prospective study performed in 5 Intensive Care Units. We measured serum sFasL concentrations on day 1 of TBI.ResultsWe found that 30-day survivor (n = 59) in comparison to non-survivor patients (n = 24) had higher GCS (p = 0.001), lower age (p = 0.004), lower APACHE-II score (p < 0.001), lower intracranial pressure (ICP) (p = 0.01), lower computer tomography (CT) findings of high risk of death (p = 0.02) and lower serum sFasL concentrations (p < 0.001). The area under the curve for mortality prediction by serum sFasL levels was of 75% (95% CI = 63%–87%; p < 0.001). In Kaplan–Meier analysis was found that patients with serum sFasL levels > 29.2 pg/mL had a higher mortality rate (Hazard ratio = 6.2; 95% CI = 2.6–14.8; p < 0.001). Multiple logistic regression analysis found an association between serum sFasL levels and mortality after controlling for GCS, age and CT findings (OR = 1.055; 95% CI = 1.018–1.094; p = 0.004), and after controlling for APACHE-II, ICP and CT findings (OR = 1.048; 95% CI = 1.017–1.080; p = 0.002).ConclusionsThe association between serum sFasL levels and 30-day mortality in TBI patients was the major novel finding of our study; however, future validation could be interesting to confirm those results. More... »

PAGES

249-254

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12028-020-01158-0

DOI

http://dx.doi.org/10.1007/s12028-020-01158-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1134343416

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33403586


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91 regression analysis
92 results
93 risk
94 samples
95 scale
96 scores
97 serum sFasL concentrations
98 serum sFasL levels
99 serum soluble Fas ligand levels
100 severity score
101 soluble Fas ligand levels
102 study
103 survivors
104 tomography findings
105 traumatic brain injury patients
106 units
107 validation
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