Observational studyCritical care (London, England)2015
Serum substance P levels are associated with severity and mortality in patients with severe traumatic brain injury.
Observational study in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Post-Traumatic Meningitis Is a Diagnostic Challenging Time: A Systematic Review Focusing on Clinical and Pathological Features.International journal of molecular sciences · 2020Pooled it
- Cytokine Responses in Severe Traumatic Brain Injury: Where There Is Smoke, Is There Fire?Neurocritical care · 2019Pooled it
- Mast Cells and Substance P: Neuroinflammatory Loops at the Molecular and Translational Clinical Levels.Biomolecules · 2026Review
- Article
- The Relationship Between Inflammation and the Development of Cerebral Ischaemia and Hypoxia in Traumatic Brain Injury-A Narrative Review.International journal of molecular sciences · 2025Review
- Role of substance P in cerebral edema and association with an estimated specific gravity of the brain and an outcome prediction in post-traumatic cerebral edema.World neurosurgery: X · 2024Article
- Identification of an Intravenous Injectable NK1 Receptor Antagonist for Use in Traumatic Brain Injury.International journal of molecular sciences · 2024Article
- Effect of acupuncture on pain and substance P levels in middle-aged women with chronic neck pain.Frontiers in neurology · 2023Article
- Neuropeptides, New Ligands of SARS-CoV-2 Nucleoprotein, a Potential Link between Replication, Inflammation and Neurotransmission.Molecules (Basel, Switzerland) · 2022Article
- A multi-staged neuropeptide response to traumatic brain injury.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Elevated Substance P Is a Risk Factor for Postoperative Delirium in Patients with Hip Fracture.BioMed research international · 2022Article
- Effect of neurokinin-1-receptor blockage on fracture healing in rats.Scientific reports · 2019Article
- Pathophysiology and treatment of cerebral edema in traumatic brain injury.Neuropharmacology · 2019Review
- NK1-r Antagonist Treatment Comparable to Decompressive Craniectomy in Reducing Intracranial Pressure Following Stroke.Frontiers in neuroscience · 2019Article
- Determining the Temporal Profile of Intracranial Pressure Changes Following Transient Stroke in an Ovine Model.Frontiers in neuroscience · 2019Article
- New prognostic biomarkers of mortality in patients undergoing liver transplantation for hepatocellular carcinoma.World journal of gastroenterology · 2018Review
- Article
- Luteinizing Hormone and Testosterone Levels during Acute Phase of Severe Traumatic Brain Injury: Prognostic Implications for Adult Male Patients.Frontiers in endocrinology · 2018Article
- Relationship between heterotopic ossification and traumatic brain injury: Why severe traumatic brain injury increases the risk of heterotopic ossification.Journal of orthopaedic translation · 2018Review
- Biomarkers Associated with the Outcome of Traumatic Brain Injury Patients.Brain sciences · 2017Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSubstance P (SP) is a member of the tachykinin family of neuropeptides, which are widely distributed throughout the central nervous system (CNS) and actively involved in inflammatory processes. SP is released early following acute injury to the CNS, promoting a neurogenic inflammatory response characterized by an increase in the permeability of the blood-brain barrier and the development of vasogenic edema. High levels of SP could lead to an exacerbated inflammatory response that could be fatal for patients with traumatic brain injury (TBI). Thus, the main goal of the present study was to determine whether serum SP levels are associated with injury severity and mortality in patients with severe TBI.
methodsThis multicenter, observational, prospective study was carried out in six Spanish intensive care units and included patients with Glasgow Coma Scale (GCS) scores ≤ 8. Patients with an Injury Severity Score ≥ 10 in non-cranial aspects were excluded. Blood samples were collected on day 1 of TBI to measure serum SP levels. The endpoint was 30-day mortality.
resultsWe found higher serum SP levels (P = 0.002) in non-surviving patients (n = 27) than in surviving patients (n = 73). The area under the curve for serum SP levels with regard to predicting 30-day mortality was 0.70 (95% confidence interval (CI), 0.60 to 0.79; P < 0.001). Survival analysis showed that patients with serum SP levels >299 pg/ml had higher 30-day mortality than patients with lower levels (hazard ratio = 3.7; 95% CI, 1.75 to 7.94; P < 0.001). Multiple binomial logistic regression analysis showed that serum SP levels >299 pg/ml were associated with 30-day mortality when we controlled for APACHE II score and Marshall computed tomography lesion classification (odds ratio (OR) = 5.97; 95% CI, 1.432 to 24.851; P = 0.01) and for GCS score and age (OR = 5.71; 95% CI, 1.461 to 22.280; P = 0.01). We found a negative association between serum SP levels and GCS score (Spearman's ρ = -0.22; P = 0.03).
conclusionsWe report, for the first time to our knowledge, that serum SP levels were associated with injury severity and mortality in patients with severe TBI. These results open the possibility that SP antagonists may be useful in the treatment of patients with severe TBI.
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Registered trials
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