Analysis of serum iron levels in patients with traumatic brain injury
Abstract
Abstract.
Decreased serum iron levels can be frequently observed in patients after traumatic brain injury.
Objectives. To investigate the dynamics of serum iron levels in patients with irreversible traumatic brain injury.
Material and methods. 107 patients with severe traumatic brain injury were included in the prospective non-randomized study. The patients were 52 (39; 60) years old; weight – 78 (70; 85) kg; 83 (77.6%) male and 24 (22.4%) female patients. Depending on the treatment outcome, 2 groups were formed: patients with a positive treatment outcome (group 1, n=56) and withan unfavorable results of intensive care (group 2, n=51), in whom the brain death was declared during treatment. In patients the serum iron levels were analyzed on the 1, 2, 3, 5, 7 and 10 days.
Results. Statistically significant differences were found between the two groups in: level of consciousness according to the Glasgow Coma Scale upon admission (12 (8; 14) points in group 1 and 5 (4; 6) points in group 2 (p<0.0001)); volume of the intracranial hematoma (76 (56; 107) ml and 150 (75; 185) ml, respectively (p=0.0057)); the volume of blood loss during surgery (293.5 (211; 505) ml and 500 (254; 750) ml, respectively (p=0.038)); severity of the condition according to the SOFA scale upon admission (3 (1; 6) points and 7.5 (6; 11) points, respectively, (p<0.0001)). No statistically significant differences in the serum iron level on the 1st and 2nd days were found: on the 1st day – 7.9 (4.1; 12.7) μmol/l in group 1 and 5.4 (2; 11.9) μmol/l in group 2 (p=0.48). On the 3rd and subsequent days of the study, statistically significant differences in the iron level between the groups of patients were observed: on the 3rd day - 5.1 (3.3; 9.8) μmol/l in group 1 and 3 (2; 4.1) μmol/l in group 2 (p=0.002).
Conclusions. Patients with the brain death have lower serum iron levels on the 3rd and subsequent days; it is associated with both greater brain damage and systemic inflammatory response syndrome, which increases significantly with brain death.
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