Serum cystatin C is correlated with mortality of traumatic brain injury patients partially mediated by acute kidney injury.

Ruoran Wang, Hongxu Chen, Min He, Jianguo Xu

Abstract readObservational Study

In one paragraph

Observational study in Acta neurologica Belgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Ruoran Wang *Department of Neurosurgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.

Hongxu Chen *Department of Neurosurgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.

Min HeDepartment of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. hemin19910306@wchscu.cn.

Jianguo XuDepartment of Neurosurgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China. xujg@scu.edu.cn.ORCID http://orcid.org/0000-0002-2285-3333

Funding

Chinese Academy of Sciences JH2022007Natural Science Foundation of China 82002655Natural Science Foundation of China 82173175West China Hospital, Sichuan University 2020HXFH036

6 · The paper itself

Abstract

backgroundEvaluating risk of poor outcome for Traumatic Brain Injury (TBI) in early stage is necessary to make treatment strategies and decide the need for intensive care. This study is designed to verify the prognostic value of serum cystatin C in TBI patients.

methods415 TBI patients admitted to West China hospital were included. Logistic regression was performed to explore risk factors of mortality and testify the correlation between cystatin C and mortality. Mediation analysis was conducted to test whether Acute Kidney Injury (AKI) and brain injury severity mediate the relationship between cystatin C level and mortality. Area under the receiver operating characteristic curve (AUC) was used to evaluate the prognostic value of cystatin C and the constructed model incorporating cystatin C.

resultsThe mortality rate of 415 TBI patients was 48.9%. Non-survivors had lower GCS (5 vs 8, p < 0.001) and higher cystatin C (0.92 vs 0.71, p < 0.001) than survivors. After adjusting confounding effects, multivariate logistic regression indicated GCS (p < 0.001), glucose (p < 0.001), albumin (p = 0.009), cystatin C (p < 0.001) and subdural hematoma (p = 0.042) were independent risk factors of mortality. Mediation analysis showed both AKI and brain injury severity exerted mediating effects on relationship between cystatin C and mortality of included TBI patients. The AUC of combining GCS with cystatin C was 0.862, which was higher than that of GCS alone (Z = 1.7354, p < 0.05).

conclusionBoth AKI and brain injury severity are mediating variables influencing the relationship between cystatin C and mortality of TBI patients. Serum cystatin C is an effective prognostic marker for TBI patients.

Indexed as

Acute Kidney InjuryBrain Injuries, TraumaticCystatin CComaHumansLogistic ModelsPrognosisRisk FactorsCST3 protein, humanCystatin CAcute kidney injuryCystatin CMediating effectMortalityTraumatic brain injury

Identifiers

PMID37171701

DOI10.1016/j.neuroscience.2004.06.024

PMCPMC10175904

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