Engi Hamdi, Khaled Taema, Mohamed Shehata, Waheed Radwan

Critical Care Medicine Department, Cairo University, Egypt

Background: Traumatic brain injury (TBI) poses a major public-health problem. Many research works aimed to identify early predictors of mortality and functional outcome. The cardiac troponin I (cTnI) elevation has also been observed in acute non traumatic head injuries and has been associated with an increased risk of mortality. Objective: This study was done to evaluate the prognostic implication of the cardiac troponin I (cTnI ( in the traumatic brain injury patients. Methods: Thirty two patients were enrolled in our prospective study (27 males, mean age 38.0±10.2 years), admitted to intensive care units in Cairo university hospitals with traumatic brain injury except those with associated co-morbidities that cause elevation of cTnI. Patients were stratified according to the severity of the injury, their outcome and prognosis using the Glasgow outcome scale(GCS),and APACHE II to be correlated with the cTnI. Results: Patients with poor prognosis following TBI were hemodynamically unstable (87 % Vs 12.5 %; P: 0.004), had lower GCS (10 Vs 6; P: 0.002), higher APACHE II score (16.8 Vs 9; P: 0.001), and higher incidence of post traumatic seizures (64 % Vs 11 %; P: 0.002). Patients with poor prognosis exhibited also a high cTnI level compared to patients with good prognosis (2.85 µg/L Vs 0.23 µg/L; P: 0.001). Conclusion: The elevated cTnI level together with lower GCS score higher APACHE II score, and the hemodynamic instability, are all good predictors for the poor outcome after TBI. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(4): 365-373]

 Key Words: TBI, Troponin I, GCS.