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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Prognostic value of targeted metabolomis in severe traumatic brain injury

Targeted Metabolomics für die Prognose des schweren Schädel-Hirn-Traumas

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Daniel Pinggera - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Aleksandrs Krigers - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Vera Reinstadler - Medizinische Universität Innsbruck, Institut für Gerichtsmedizin und Core Facility Metabolomics, Innsbruck, Österreich
  • Ronny Beer - Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Österreich
  • Raimund Helbok - Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Österreich
  • Herbert Oberacher - Medizinische Universität Innsbruck, Institut für Gerichtsmedizin und Core Facility Metabolomics, Innsbruck, Österreich
  • Claudius Thomé - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Ondra Petr - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP113

doi: 10.3205/22dgnc423, urn:nbn:de:0183-22dgnc4239

Veröffentlicht: 25. Mai 2022

© 2022 Pinggera et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objective: Severe traumatic brain injury (sTBI) represents a serious public health issue potentially resulting in poor outcome, therefore early prognosis is of capital relevance. The aim of this study was to investigate metabolite levels in serum in their time-dependent course after severe TBI related to clinical outcome.

Methods: Patients with sTBI admitted to our neurosurgical ICU from 03/2015 to 12/2017 were prospectively included in the study. Serum samples were consecutively collected on a daily base for 10 days. The endogenous metabolites were analyzed with a targeted quantitative and quality controlled metabolomics approach using the AbsoluteIDQ®p150Kit. Longitudinal time course of numerous metabolites related to favorable (GOS 4-5) and unfavorable outcomes (GOS 1-3) was evaluated. Patient outcome was assessed systematically at follow-up examinations at the Department of Neurosurgery 3 to 6 months after discharge.

Results: Samples of 31 patients (5 female, 26 male), with a mean GCS of 6 and aged 20 to 75 years were analyzed. Patients with an unfavorable outcome showed significantly elevated serum levels of essential amino acids (histidine, leucine, threonine, tryptophane, tyrosine und valine) on day 5 after sTBI. Logistic regression showed an accuracy of 59.2 % (Nagelkerke R Square ­0.592 / 59.2%). Of these, valine tended to be the most promising with an odds ratio of 1.049 (CI95%: 1.007 – 1.093).

Conclusion: Elevation of several essential amino acids in serum on day 5 after sTBI appears to be associated with an unfavorable outcome. Some of them may represent promising potential predictive biomarkers that can be evaluated in laboratory routine without additional invasive methods. Larger clinical studies are required to confirm our findings. This could be due to increase of neuronal cell death with elevated extracellular release of metabolites or reduced synthesis of downstream neurotransmitters.