Biochemical markers indicating a high risk for infectious complications in patients with combined traumatic brain injury

Background and objectives

Combined traumatic brain injury (CTBI) remains a leading cause of disability/mortality among workers, yet which routine biochemical tests that predict infectious complications remain controversial. We aimed to identify the most informative serum markers for early diagnosis and prognosis of such complications.

Methods

In this retrospective observational study, 80 acute CTBI patients (40 without vs. 40 with mainly bacterial infectious complications) and 40 healthy controls were analyzed. Serum collected at 24, 72, and 168 h was assayed for protein fractions, metabolic markers, lipid peroxidation indices, antioxidant activity, endogenous intoxication markers, acids/minerals, and relevant enzymes.

Results

The study found that the most important prognostic indicator for infectious complications was a simultaneous increase in α1-globulins, β-globulins, diene conjugates, superoxide dismutase, medium- and low-molecular-weight substances in erythrocytes, erythrocyte oligopeptides, and lactate at 24 h after injury (p < 0.001). A significant increase in sialic acids, uronic acids, total Ca and P, and low-density lipoproteins was observed at 72 h after injury (p < 0.001). Notably, individual components from the 24-h panel demonstrated high standalone predictive value, with areas under the curve of diene conjugates (0.91), erythrocyte oligopeptides (0.87), β-globulin (0.86), α1-globulin (0.82), and superoxide dismutase (0.82), respectively. The elevation of these biomarker profiles was significantly correlated with worse clinical outcomes, including longer intensive care unit stay and ventilation duration.

Conclusions

This study identified a set of biochemical markers associated with infectious complications in patients with CTBI. These biochemical parameters may serve as additional diagnostic and prognostic criteria for the management of infectious complications in patients with СTBI.

Full text:

https://www.xiahepublishing.com/3067-6150/NSSS-2025-00042

The study was recently published in the Neurosurgical Subspecialties.

Neurosurgical Subspecialties (NSSS) is the official scientific journal of the Department of Neurosurgery at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. NSSS aims to provide a forum for clinicians and scientists in the field, dedicated to publishing high-quality and peer-reviewed original research, reviews, opinions, commentaries, case reports, and letters across all neurosurgical subspecialties. These include but are not limited to traumatic brain injury, spinal and spinal cord neurosurgery, cerebrovascular disease, stereotactic radiosurgery, neuro-oncology, neurocritical care, neurosurgical nursing, neuroendoscopy, pediatric neurosurgery, peripheral neuropathy, and functional neurosurgery.

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