@article{ref1,
title="High serum soluble fas ligand levels in non-survivor traumatic brain injury patients",
journal="Neurocritical care",
year="2021",
author="González-Rivero, Agustín F. and Pérez-Cejas, Antonia and Jiménez, Alejandro and Ferrer-Moure, Carmen and Alvarez-Castillo, Andrea and Cabrera, Judith and Cáceres, Juan J. and Solé-Violán, Jordi and Martín, María M. and Lorente, Leonardo and Ramos-Gómez, Luis",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Soluble Fas Ligand (sFasL) is one of the main ligands that activates the apoptosis extrinsic pathway. Higher expression of FasL in brain samples and higher  cerebrospinal fluid FasL concentrations in traumatic brain injury (TBI) patients  than in controls have been found. However, the potential association between blood  sFasL concentrations and TBI mortality has not been reported. Therefore, the  objective of this study was to determine whether that association exists. <br><br>METHODS:  We included patients with a severe isolated TBI, defined as < 9 points in Glasgow  Coma Scale (GCS) and < 10 non-cranial aspects points in Injury Severity Score in  this observational and prospective study performed in 5 Intensive Care Units. We  measured serum sFasL concentrations on day 1 of TBI. <br><br>RESULTS: We found that 30-day  survivor (n = 59) in comparison to non-survivor patients (n = 24) had higher GCS  (p = 0.001), lower age (p = 0.004), lower APACHE-II score (p < 0.001), lower  intracranial pressure (ICP) (p = 0.01), lower computer tomography (CT) findings of  high risk of death (p = 0.02) and lower serum sFasL concentrations (p < 0.001). The  area under the curve for mortality prediction by serum sFasL levels was of 75% (95%  CI = 63%-87%; p < 0.001). In Kaplan-Meier analysis was found that patients with  serum sFasL levels > 29.2 pg/mL had a higher mortality rate (Hazard ratio = 6.2; 95%  CI = 2.6-14.8; p < 0.001). Multiple logistic regression analysis found an  association between serum sFasL levels and mortality after controlling for GCS, age  and CT findings (OR = 1.055; 95% CI = 1.018-1.094; p = 0.004), and after controlling  for APACHE-II, ICP and CT findings (OR = 1.048; 95% CI = 1.017-1.080; p = 0.002). <br><br>CONCLUSIONS: The association between serum sFasL levels and 30-day mortality in TBI  patients was the major novel finding of our study; however, future validation could  be interesting to confirm those results.<p /> <p>Language: en</p>",
language="en",
issn="1541-6933",
doi="10.1007/s12028-020-01158-0",
url="http://dx.doi.org/10.1007/s12028-020-01158-0"
}