Plasma Interleukin-8 as a Potential Predictor of Mortality in Adult Patients with Severe Traumatic Brain Injury

Plasma Interleukin-8 as a Potential Predictor of Mortality in Adult Patients with Severe Traumatic Brain Injury

ALEKSANDAR GOPCEVIC,¹ BRANKA MAZUL-SUNKO,¹ JASMINKA MAROUT,² ANTE SEKULIC,³ NATASA ANTOLJAK,⁴ MLADEN SIRANOVIC,¹ ZELJKO IVANEC,¹ MARKO MARGARITONI,⁵ MIROSLAV BEKAVAC-BESLIN⁶ and NEVEN ZARKOVIC⁷

¹Department of Anesthesiology and Intensive Care, University Hospital Sestre Milosrdnice, Zagreb, Croatia
²Laboratory of Endocrinology, University Hospital Sestre Milosrdnice, Zagreb, Croatia
³University Department of Anesthesiology, Zagreb, Division of Neuroanesthesia and Neurointensive Care, University Hospital Zagreb, Croatia
⁴Institute of Public Health, Zagreb, Croatia
⁵General Hospital, University of Dubrovnik, Dubrovnik, Croatia
⁶Department of Surgery, University Hospital Sestre Milosrdnice, Zagreb, Croatia
⁷Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia

Because of complex pathophysiology and severe consequences, traumatic brain injuries (TBI) are an important medical problem. Pathophysiology of TBI includes local and systemic stress response, in which interleukin-8 (IL-8) is considered as a key mediator of neuroinflammation. However, prognostic relevance of IL-8 measurement in adult patients with severe TBI is not certain. Therefore, IL-8 was determined in blood samples from central venous and jugular bulb catheter and in cerebrospinal fluid of twenty patients with isolated TBI at admission to Intensive Care Unit. None of the patients had history of stroke, dementia, autoimmune diseases, acute infection or medication with anti-inflammatory drugs. Ten patients died due to traumatic brain injury, while the other ten recovered well. While there was no significant difference of IL-8 levels in cerebrospinal fluid between survivors and nonsurvivors, central venous plasma level of IL-8 was significantly lower in survivors (71.00 ± 14.17 pg/ml), than in nonsurvivors (111.26 ± 16.9 pg/ml). Receiver Operating Characteristic (ROC) analysis revealed significant prognostic value for IL-8 in the blood as well as for the age of patients, Glasgow Coma Scale (GCS) and Acute Physiologic and Chronic Health Evaluation (APACHE II). These findings suggest that the central venous plasma values of IL-8 at admission might be an early predictive marker in patients with severe TBI, comparative to standard clinical prognostic markers such as APACHE II and GCS.

keywords —— traumatic brain injury (TBI); coma; mortality; inflammation; Interleukin-8 (IL-8)

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Tohoku J. Exp. Med., 2007, 211, 387-393

Correspondence: Neven Zarkovic, M.D., Ph.D., Senior Scientist, Rudjer Boskovic Institute, Bijenicka 54, HR-1000 Zagreb, Croatia.

e-mail: zarkovic@irb.hr