[Plasma variations in severe head injuries: prognosis and post-traumatic surveillance. I. Enzymes]

Variations of four enzymatic activities (aldolase, aspartate aminotransferase, creatine kinase and lactate dehydrogenase) were followed in human plasma for four days after head injury. Univariate analysis showed that each plasma enzyme activity significantly differed as early as 72 h after head injury according to the clinical evolution (survival or death). Multivariate analysis performed with these four tests allowed us to correctly divide, in terms of survival or death, 75 to 91% of unselected patients (n = 280). Combining these four tests increased discriminant power in severe head injury. Most of the patients who were misclassified according to their biochemical data received phenobarbital for treatment. Valuable prognostic information may thus be obtained by daily determinations of four enzymatic activities.