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BioMed Research International
Volume 2014, Article ID 720870, 11 pages
http://dx.doi.org/10.1155/2014/720870
Research Article

Serial Serum Leukocyte Apoptosis Levels as Predictors of Outcome in Acute Traumatic Brain Injury

1Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
2Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
3Division of Neurosurgery, Department of Surgery, Yuan’s General Hospital, Kaohsiung 80249, Taiwan
4Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
5Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
6Departments of Neurosurgery, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
7Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

Received 2 February 2014; Accepted 26 March 2014; Published 17 April 2014

Academic Editor: Kuang-I Cheng

Copyright © 2014 Hung-Chen Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Apoptosis associates with secondary brain injury after traumatic brain injury (TBI). This study posits that serum leukocyte apoptosis levels in acute TBI are predictive of outcome. Methods. Two hundred and twenty-nine blood samples from 88 patients after acute TBI were obtained on admission and on Days 4 and 7. Serial apoptosis levels of different leukocyte subsets were examined in 88 TBI patients and 27 control subjects. Results. The leukocyte apoptosis was significantly higher in TBI patients than in controls. Brief unconsciousness (), motor deficits (), GCS (), ISS (), WBC count (), late apoptosis in lymphocytes and monocytes on Day 1 ( and , resp.), subdural hemorrhage on initial brain CT (), neurosurgical intervention (), and acute posttraumatic seizure () were significant risk factors of outcome. Only motor deficits () and late apoptosis in monocytes on Day 1 () were independently associated with outcome. A cutoff value of 5.72% of late apoptosis in monocytes was associated with poor outcome in acute TBI patients. Conclusion. There are varying degrees of apoptosis in patients following TBI and in healthy individuals. Such differential expression suggests that apoptosis in different leukocyte subsets plays an important role in outcome following injury.