Concussionology® - Master The Complex
Research 46
Inflammation Has Unfavorable outcome In Car Accidents
Comments by Dr. Mladenoff
Car accidents is one of the leading causes of concussion including all sports events. Blood samples were taken within 6 hours of head trauma. The Glascow Outcome Scale was determined at 6 months.
The authors conclude that increased levels of inflammatory hormones IL-6 and IL-8 should be considered as a marker for unfavorable outcome. The authors are prudent to not use verbage such as ominous outcome or even death.
There is elevation IL6 and IL8 in all patients examined and thus represents a significant treatment strategy to down regulate this inflammatory cytokines.
There was also elevated IL-10 levels
The Relationship Between Serum Levels of Interleukins 6, 8, 10 and Clinical Outcome in Patients With Severe Traumatic Brain Injury.
Arch Trauma Res. 2015 Mar; 4(1): e18357.
Published online 2015 Feb 20. doi: 10.5812/atr.18357
Abstract
Background: Clinical outcome in patients with severe traumatic brain injury (TBI) depends on both primary and secondary brain injuries. Neuroinflammation is an important secondary mechanism, which occurs by releasing interleukins (ILs). Increased levels of ILs may affect clinical outcome following TBI.
Objectives: This study aimed to determine the relationship between the serum levels of interleukins 6, 8 and 10 and clinical outcome in patients with severe TBI 6 months after injury.
Patients and Methods: In a descriptive-analytical study, 44 patients with GCS ≤ 8 (Glasgow coma scale) and age ≥ 14 years were included. Their blood samples were collected at first 6 hours after injury. Clinical outcome was determined based on GOS (Glasgow Outcome Scale) at 6 months after head injury. Serum levels of interleukins 6, 8 and 10 were measured using the ELISA method. Spearman's rho, independent T-Test, and Mann-Whitney Test were used for data analysis.
Results: Comparing the serum levels of interleukins in two groups with favorable and unfavorable clinical outcomes showed that the mean serum levels of interleukins 6 and 8 in group with favorable outcome was 85.2 ± 51.6 and 52.2 ± 31.9, respectively lower than those of group with unfavorable outcome with 162.3 ± 141.1 and 173.6 ± 257.3 (P < 0.03) and (P < 0.01).
Conclusions: Increased serum levels of interleukins 6 and 8 as a predictive marker might be associated with unfavorable clinical outcome in patients with severe TBI.
Final Discussion: From a total of 44 patients included in this study, 97.7% were male and the rest were female with the mean ages of 33.7 ± 17.6 years. Accidents caused by motor vehicle crashes (97.7%) were the most common cause of trauma. Results of patients outcome at 6 months after head injury based on GOS showed that 56.4% of the patients died, 2.6% had vegetative life, 25.6% severe disability, 10.3% moderate disability, and 5.1% good recovery. Based on the previous classification, it can be said that 15.4% had favorable and 84.6% unfavorable outcome. Mean ages in favorable and unfavorable outcome groups were 36.7 ± 8.6 and 33.1 ± 17.5, respectively and there was no statistically significant correlation between mean age of groups. Mean GCS at admission time in group with favorable outcome was 5.7 ± 1.7, while in other group, mean GCS was 5.1 ± 1.5 suggesting that there is no statistically significant correlation. Serum levels of interleukin 8 (P < 0.01) and interleukin 6 (P < 0.03) were significantly higher in groups with unfavorable outcomes comparing to favorable outcome; however, no statistically significant difference was observed in serum level of IL -10 in the two groups.
Arch Trauma Res. 2015 Mar; 4(1): e18357.
Published online 2015 Feb 20. doi: 10.5812/atr.18357
Abstract
Background: Clinical outcome in patients with severe traumatic brain injury (TBI) depends on both primary and secondary brain injuries. Neuroinflammation is an important secondary mechanism, which occurs by releasing interleukins (ILs). Increased levels of ILs may affect clinical outcome following TBI.
Objectives: This study aimed to determine the relationship between the serum levels of interleukins 6, 8 and 10 and clinical outcome in patients with severe TBI 6 months after injury.
Patients and Methods: In a descriptive-analytical study, 44 patients with GCS ≤ 8 (Glasgow coma scale) and age ≥ 14 years were included. Their blood samples were collected at first 6 hours after injury. Clinical outcome was determined based on GOS (Glasgow Outcome Scale) at 6 months after head injury. Serum levels of interleukins 6, 8 and 10 were measured using the ELISA method. Spearman's rho, independent T-Test, and Mann-Whitney Test were used for data analysis.
Results: Comparing the serum levels of interleukins in two groups with favorable and unfavorable clinical outcomes showed that the mean serum levels of interleukins 6 and 8 in group with favorable outcome was 85.2 ± 51.6 and 52.2 ± 31.9, respectively lower than those of group with unfavorable outcome with 162.3 ± 141.1 and 173.6 ± 257.3 (P < 0.03) and (P < 0.01).
Conclusions: Increased serum levels of interleukins 6 and 8 as a predictive marker might be associated with unfavorable clinical outcome in patients with severe TBI.
Final Discussion: From a total of 44 patients included in this study, 97.7% were male and the rest were female with the mean ages of 33.7 ± 17.6 years. Accidents caused by motor vehicle crashes (97.7%) were the most common cause of trauma. Results of patients outcome at 6 months after head injury based on GOS showed that 56.4% of the patients died, 2.6% had vegetative life, 25.6% severe disability, 10.3% moderate disability, and 5.1% good recovery. Based on the previous classification, it can be said that 15.4% had favorable and 84.6% unfavorable outcome. Mean ages in favorable and unfavorable outcome groups were 36.7 ± 8.6 and 33.1 ± 17.5, respectively and there was no statistically significant correlation between mean age of groups. Mean GCS at admission time in group with favorable outcome was 5.7 ± 1.7, while in other group, mean GCS was 5.1 ± 1.5 suggesting that there is no statistically significant correlation. Serum levels of interleukin 8 (P < 0.01) and interleukin 6 (P < 0.03) were significantly higher in groups with unfavorable outcomes comparing to favorable outcome; however, no statistically significant difference was observed in serum level of IL -10 in the two groups.