Artikel
Significance of CSF markers for detection of ventriculitis in patients with EVD after traumatic brain injury
Ventrikulitis bei externer Ventrikeldrainage nach Schädel-Hirn-Trauma – retrospektive Analyse zur prognostischen Wertigkeit von Biomarkern in Serum und Liquor
Suche in Medline nach
Autoren
Veröffentlicht: | 8. Mai 2019 |
---|
Gliederung
Text
Objective: The aim of this study was to investigate in patients with traumatic brain injury and external ventricular drain the diagnostic potential of inflammatory markers in cerebro-spinal fluid (CSF) and serum (S) (CSF_IL-6, CSF_total leucocyte count, CSF_protein, S_CRP, S_white blood cell count) for the early diagnosis of ventriculitis (VC_TBI) compared to patients without ventriculitis (TBIw/o/v).
Methods: Retrospective data from 40 consecutive patients with traumatic brain injury (TBI) and external ventricular drainage (EVD) were analysed. For all markers arithmetical means and standard deviations, area under the curve (AUC), cutoff values (C-OFF), sensitivity (SE), specificity (SP), positive (+LR) and negative Likelihood-Ratio (-LR) were calculated and correlated with VC_TBI and TBIw/o/v.
Results: Clinical courses included 35 patients with TBIw/o/v and 5 patients with VC_TBI. Mean ± standard deviation of CSF_IL-6 values were 6519±4268 pg/ml at onset of VCTBI as compared to 1065±1705 pg/ml without (p=0.04). CSF_IL-6 showed excellent diagnostic potential for differing between VC_TBI and TBIw/o/v (AUC=0.938, C-OFF=4064 pg/ml, SE=100%, SP=92.3%, +LR= 13, -LR=0), followed by CSF_ total leucocyte count (AUC=0.900, C-OFF=65 /µL, SE= 100%, SP=80, +LR=5.0, -LR=0) and CSF_protein (AUC=0.875, C-OFF=32 mg/dl, SE=100%, SP=63%, +LR=2.7, -LR=0).
Conclusion: CSF_IL-6 is significantly increased in patients with ventriculitis after TBI. Patients with a CSF_IL-6 level higher than the threshold of 4064 pg/ml have a significantly increased posttest probability for VC_TBI. Therefore CSF_IL-6 is a useful early marker for diagnosing ventriculitis in TBI patients.
Figure 1 [Fig. 1]