Publish in this journal
Journal Information
Vol. 45. Issue 3.
Pages 131-137 (April 2021)
Share
Share
Download PDF
More article options
ePub
Visits
...
Vol. 45. Issue 3.
Pages 131-137 (April 2021)
Original article
DOI: 10.1016/j.medine.2019.09.009
Serum caspase-3 levels during the first week of traumatic brain injury
Niveles séricos de caspasa-3 durante la primera semana de un traumatismo craneoencefálico
Visits
...
L. Lorentea,
Corresponding author
lorentemartin@msn.com

Corresponding author.
, M.M. Martínb, A. Pérez-Cejasc, A.F. González-Riverod, M. Arguesoe, L. Ramosf, J. Solé-Violáng, J.J. Cáceresh, A. Jiménezi, V. García-Marínj
a Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
b Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
c Laboratory Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
d Laboratory Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
e Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain
f Intensive Care Unit, Hospital General de La Palma, Breña Alta, La Palma, Spain
g Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Las Palmas de Gran Canaria, Spain
h Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Spain
i Research Unit, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
j Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (3)
Table 1. Characteristics on admission of 30-day surviving and non-surviving patients.
Table 2. Thirty-day mortality prognostic capability of serum caspase-3 levels at day 1, 4 and 8 of trauma brain injury.
Table 3. Multiple logistic regression analysis to predict 30-day mortality.
Show moreShow less
Abstract
Objective

Confluence between the intrinsic and extrinsic apoptosis pathways is reached at the point of caspase-3 activation, which induces death cell. Higher serum caspase-3 levels have been recorded on day 1 of traumatic brain injury (TBI) in 30-day non-survivors compared to survivors. The objectives of this study therefore were to determine whether serum caspase-3 levels are persistently higher in non-survivors than in survivors, and whether these levels may be used to predict 30-day mortality.

Design

A prospective observational study was carried out.

Setting

Six Spanish Intensive Care Units.

Patients

Patients with severe isolated TBI (defined as Glasgow Coma Scale <9 points and non-cranial Injury Severity Score <10 points).

Interventions

Serum caspase-3 concentrations were measured on days 1, 4 and 8 of TBI.

Main variables of interest

Thirty-day mortality was considered as the study endpoint.

Results

In comparison with non-survivors (n=34), 30-day survivors (n=90) showed lower serum caspase-3 levels on days 1 (p=0.001), 4 (p<0.001) and 8 (p<0.001) of TBI. Analysis of the ROC curves showed serum caspase-3 concentrations on days 1, 4 and 8 of TBI to have an AUC (95% CI) in predicting 30-day mortality of 0.70 (0.61–0.78; p=0.001), 0.83 (0.74–0.89; p<0.001) and 0.87 (0.79–0.93; p<0.001), respectively.

Conclusions

The novel findings of our study were that serum caspase-3 levels during the first week of TBI were lower in survivors and could predict 30-day mortality.

Keywords:
Caspase-3
Patients
Mortality
Traumatic
Brain injury
Resumen
Objetivo

La vía intrínseca y extrínseca de la apoptosis confluyen en la activación de caspasa-3. Se han encontrado mayores niveles séricos de caspasa-3 en el día 1 del traumatismo craneoencefálico (TCE) en los pacientes que fallecen en los primeros 30 días que en supervivientes. Por tanto, los objetivos de este estudio es determinar si los niveles séricos de caspasa-3 se mantienen superiores en los pacientes fallecidos que en los supervivientes, y si podrían utilizarse para predecir la mortalidad a 30 días.

Diseño

Estudio observacional y prospectivo.

Ámbito

Seis unidades de cuidados intensivos españolas.

Pacientes

Enfermos con un TCE grave y aislado (definido como escala de coma de Glasgow <9 y puntuación de gravedad de la lesión Score en lesiones no craneales <10).

Intervenciones

Se midieron los niveles séricos de caspasa-3 en los días 1, 4 y 8 del TCE.

Variables de interés principales

Mortalidad a los 30 días.

Resultados

Los pacientes supervivientes a los 30 días (n=90) presentan menores niveles séricos de caspasa-3 en los días 1 (p=0,001), 4 (p<0,001) y 8 (p<0,001) del TCE que los fallecidos (n=34). Los niveles séricos de caspasa-3 en los días 1, 4 y 8 del TCE tenían un área bajo la curva (intervalo de confianza del 95%) para predecir la mortalidad de 0,70 (0,61-0,78; p=0,001), 0,83 (0,74-0,89; p<0,001) y 0,87 (0,79-0,93; p<0,001), respectivamente.

Conclusiones

Los nuevos hallazgos de nuestro estudio fueron que los niveles séricos de caspasa-3 durante la primera semana del TCE fueron menores en los pacientes supervivientes, y que pueden predecir la mortalidad a los 30 días.

Palabras clave:
Caspasa-3
Pacientes
Mortalidad
Trauma
Craneoencefálico

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?