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Application of NT-proBNP in judging the severity of traumatic brain injury |
JIANG Da-peng, ZHANG Li-yuan |
(Department of Emergency Center, the Affiliated People′s Hospital of Jiangsu University, Zhenjiang Jiangsu 212000, China) |
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Abstract Objective: To detect the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in patients with early traumatic brain injury(TBI) in order to discuss the application in evaluating the severity and prognosis. Methods: Sixty-six early TBI patients were selected in the study and divided into mild group(GCS 13-15, n=27), moderate group(GCS 9-12, n=21), severe group (GCS 3-8, n=18) according to the initial Glasgow coma score (GCS). The levels of NT-proBNP, glucose(Glu), white blood cell(WBC), GCS, head abbreviated injury score(AIS) and Glasgow outcome scale(GOS) were determined. According to the discharge GOS score, patients were divided into poor prognosis group(GOS 1-2, n=16) and good prognosis group (GOS 3-5, n=50); NT-proBNP concentrations from different groups were compared. The validity of NT-proBNP for predicting outcome was analyzed by receiver operating characteristic(ROC) curve. The correlation between NT-proBNP concentrations and GCS, head AIS, Glu, WBC was analyzed. Results: NT-proBNP concentration was increased significantly in the severe TBI group compared to mild and moderate TBI groups. NT-proBNP concentrations were significantly higher in the poor prognosis group than that in the good prognosis group (P<0.05). The best threshold value of NT-proBNP to predict the outcome was 112 pg/mL (sensitivity 0.875, specificity 0.900), NT-proBNP were positively correlated with head AIS, Glu, WBC, while negatively correlated GCS. Conclusion: The serum NT-proBNP levels in patients with early TBI seems to be a reference index for evaluating their severity and prognosis.
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Received: 15 July 2014
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