Association of Serum Uric Acid Level with the Severity of Brain Injury and Patient’s Outcome in Severe Traumatic Brain Injury

Abstract

Introduction: The prognostic value of serum Uric Acid (UA) levels in Traumatic Brain Injury (TBI) is unclear. Aim: To investigate the relationship between serum UA levels and prognosis of patients with TBI when in hospital and at six months after discharge. Materials and Methods: All patients attended our emergency department during July 2014 and December 2015 and were consecutively entered into the study and among 890 evaluated candidates based on inclusion criteria we finally investigated the serum UA levels of 725 TBI patients. Computed Tomography (CT) images of the brain were obtained within the first 24 hours of hospitalization. Outcome was assessed using the Glasgow Outcome Scale (GOS) score at discharge and at six months after discharge. Results: Data of 725 patients (42.89% men; mean age: 54.69±12.37 years) were analyzed. Mean±Standard Deviation (SD) of Glasgow Coma Scale (GCS) scores was 4.65±1.76. Serum levels of UA, when in hospital and at six months after discharge, among those who died were lower than those who survived (in hospital: 0.126±0.026 vs. 0.243±0.942 mmol/l, p = 0.000; 6 months post-discharge: 0.130±0.044 vs. 0.286±0.069 mmol/l, p<0.001). The mean UA plasma was significantly different between deceased and alive patients according to GOS scores (p<0.001 and p=0.030, respectively). The UA levels showed a significant relationship with GCS scores and severity of brain injury assessed using the Marshall Classification Score (p=0.005). Conclusion: Our results showed a strong relationship between UA levels and patients' outcomes either in hospital or at six months after discharge. Serum UA level could be considered as a valuable marker for evaluating the severity of brain injury and outcomes of TBI.

Keywords

• computed tomography scan
• glasgow coma scale
• outcome
• prognosis