TY - JOUR T1 - Serum caspase-3 levels during the first week of traumatic brain injury JO - Medicina Intensiva (English Edition) T2 - AU - Lorente,L. AU - Martín,M.M. AU - Pérez-Cejas,A. AU - González-Rivero,A.F. AU - Argueso,M. AU - Ramos,L. AU - Solé-Violán,J. AU - Cáceres,J.J. AU - Jiménez,A. AU - García-Marín,V. SN - 21735727 M3 - 10.1016/j.medine.2019.09.009 DO - 10.1016/j.medine.2019.09.009 UR - https://www.medintensiva.org/en-serum-caspase-3-levels-during-first-articulo-S2173572721000278 AB - ObjectiveConfluence between the intrinsic and extrinsic apoptosis pathways is reached at the point of caspase-3 activation, which induces death cell. Higher serum caspase-3 levels have been recorded on day 1 of traumatic brain injury (TBI) in 30-day non-survivors compared to survivors. The objectives of this study therefore were to determine whether serum caspase-3 levels are persistently higher in non-survivors than in survivors, and whether these levels may be used to predict 30-day mortality. DesignA prospective observational study was carried out. SettingSix Spanish Intensive Care Units. PatientsPatients with severe isolated TBI (defined as Glasgow Coma Scale <9 points and non-cranial Injury Severity Score <10 points). InterventionsSerum caspase-3 concentrations were measured on days 1, 4 and 8 of TBI. Main variables of interestThirty-day mortality was considered as the study endpoint. ResultsIn comparison with non-survivors (n=34), 30-day survivors (n=90) showed lower serum caspase-3 levels on days 1 (p=0.001), 4 (p<0.001) and 8 (p<0.001) of TBI. Analysis of the ROC curves showed serum caspase-3 concentrations on days 1, 4 and 8 of TBI to have an AUC (95% CI) in predicting 30-day mortality of 0.70 (0.61–0.78; p=0.001), 0.83 (0.74–0.89; p<0.001) and 0.87 (0.79–0.93; p<0.001), respectively. ConclusionsThe novel findings of our study were that serum caspase-3 levels during the first week of TBI were lower in survivors and could predict 30-day mortality. ER -