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Published on: May 27, 2022
Serum Substance P Concentration in Children With Traumatic Brain Injury: A First Report
Ying Zhou1, Hui Ye1, Weifeng Lu1
1Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Serum substance P (SP) levels are elevated in children with traumatic brain injury (TBI). Higher SP concentrations correlate with increased severity and mortality risk in pediatric TBI patients.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Biochemistry
Background:
- Traumatic brain injury (TBI) in children presents diagnostic and prognostic challenges.
- Assessing TBI severity and predicting outcomes are critical for effective clinical management.
Purpose of the Study:
- To evaluate the clinical utility of serum substance P (SP) concentration for assessing TBI severity in children.
- To analyze the correlation between SP levels and patient outcomes, including mortality.
Main Methods:
- A cohort of 139 children with TBI was analyzed, with serum SP levels measured within 24 hours post-injury.
- Serum SP concentrations were compared between TBI patients and healthy controls, and between survivors and non-survivors.
- Clinical severity was assessed using Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA), and Pediatric Clinical Illness Score (PCIS).
Main Results:
- Serum SP levels were significantly higher in children with TBI compared to controls (89.10 ± 64.32 vs. 21.84 ± 2.09 pmol/L).
- Elevated SP concentrations were observed in non-survivors compared to survivors (182.81 ± 58.39 vs. 59.93 ± 27.90 pmol/L).
- Serum SP showed a negative correlation with GCS scores and was identified as an independent risk factor for mortality, with comparable predictive power to SOFA and PCIS.
Conclusions:
- Serum SP concentration is associated with TBI severity in pediatric patients.
- Extremely high serum SP levels indicate a poor prognosis and increased mortality risk.
- SP may serve as a valuable biomarker for TBI severity assessment and outcome prediction in children.
Objective:
To review the clinic value and severity assessment of serum substance P (SP) concentration in children with different degrees of traumatic brain injury (TBI) through analyzing correlations with outcomes.
Methods:
One hundred thirty-nine children with TBI who were diagnosed and treated at Nanjing Medical University for longer than 72 hours between June 2017 and 2019 were analyzed. Blood samples were obtained within 24 hours after TBI to measure SP concentration. The endpoint was discharge mortality. Thirty healthy children composed the control group. Comparative analyses of differences in SP concentration were conducted for the different groups. Both the Sequential Organ Failure Assessment (SOFA) scores and Pediatric Clinical Illness Score (PCIS) were measured on admission and used in univariate and multivariate analyses.
Results:
The serum SP (89.10 ± 64.32) pmol/L) level in the case group was significantly higher than that in the control group (21.84 ± 2.09) pmol/L (t = 5.71, P < 0.05). The serum SP (182.81 ± 58.39) pmol/L) level in the deceased group was significantly higher than that in the survival group (59.93 ± 27.90) pmol/L (t = 16.52, P < 0.05). A negative correlation existed between serum SP concentration and Glasgow Coma Scale score in the severe, moderate, and mild groups (r = -0.72, P < 0.05). Serum SP concentration was identified as an independent risk factor for mortality (odds ratio >1, 95% confidence interval = 1.04-1.28, P < 0.01). Receiver operating characteristic curve analysis suggested that serum SP concentration had the same calibrating power as SOFA and PCIS in discriminating the risk of death of children.
Conclusions:
Serum SP concentration was associated with severity in children with TBI, and extremely high levels indicated a poor prognosis.
