Anest. intenziv. Med. 2010;21(6):331-336

Dynamics of the neurofilament pNF-H as a predictor of mortality in children with brain injuryIntensive Care Medicine - Original Paper

Žurek Jiří^1,2,*, Baštáková Lenka¹, Mihalčin Matúš¹, Forbelská Marie³, Fedora Michal^1,2

¹ Lékařská fakulta, Masarykova univerzita, Brno

² Klinika dětské anesteziologie a resuscitace, Fakultní nemocnice Brno

³ Ústav matematiky a statistiky, Přírodovědecká fakulta, Masarykova univerzita, Brno

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.

Keywords: head injury; neurofilament; biomarker; dynamics; children

Received: May 16, 2010; Accepted: September 21, 2010; Published: December 1, 2010  Show citation