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Citation
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Blackwell LS, Martinez M, Fournier-Goodnight A, Figueroa J, Appert A, Vats A, Wali B, Sayeed I, Reisner A. J. Pediatr. 2020; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine levels of plasma osteopontin (OPN), a recently described neuroinflammatory biomarker, in children with abusive head trauma compared with other types of traumatic brain injury.
STUDY DESIGN: Patients included children <4 years diagnosed with TBI and seen in the ICU in a tertiary children's hospital. Patients were classified as having confirmed or suspected abusive head trauma, or TBI by other mechanisms (eg, motor vehicle accidents), as identified by a Child Protection Team clinician. Serial blood samples were collected at admission, 24, 48, and 72 hours after admission. Levels of OPN were compared across groups.
RESULTS: Of 77 patients identified, 24 had confirmed AHT, 12 suspected AHT, and 41 had TBI. No differences were found in Glasgow Coma Scale score between confirmed AHT and the other TBI mechanism groups (median score 4.5 vs. 4 and 7; p = 0.39). At admission to the emergency department, OPN levels were significantly higher in children with confirmed AHT compared with other TBI etiologies (mean confirmed AHT = 471.5 ng/ml; median suspected AHT = 322.3 ng/ml; mean TBI = 278.0 ng/ml; p =.03). Furthermore, adjusted mean trajectory levels of OPN were significantly higher for confirmed AHT compared with other mechanisms across all subsequent time points (p = <.01).
CONCLUSIONS: OPN is significantly elevated in children with confirmed AHT compared with other TBI. OPN expression may help identify children with suspected AHT in order to aid resource stratification and triage of appropriate interventions for children who are potential victims of abuse.
Language: en |