Background

Tissue kallikrein (TK) plays an important role in the kallikrein-kinin system. Its protective role has been demonstrated in traumatic brain injury (TBI). We attempted to determine relationship between serum TK levels and trauma severity in addition to clinical outcome in TBI.

Methods

We recruited 112 patients with severe TBI (Glasgow coma scale score < 9) and 112 controls. We configured 2 multivariate models to assess the relationship between serum TK levels and 30-day death. Its prognostic predictive ability was analyzed under receiver operating characteristic curve.

Results

TK levels were significantly lower in patients than in controls (median 0.148 mg/l, the upper - lower quartiles 0.121–0.185 vs. median 0.258 mg/l, the upper - lower quartiles 0.207–0.342, P < 0.001). TK levels were closely and positively correlated with Glasgow coma scale score (r = 0.550). TK levels <0.148 mg/l independently predicted 30-day mortality with odds ratio value of 4.752 (95% confidence interval (CI), 1.166–19.367) and 30-day overall survival with hazard ratio value of 3.698 (95% CI, 1.026–13.333). TK levels significantly discriminated 30-day mortality with area under curve of 0.822 (95% CI, 0.738–0.887).

Conclusions

Serum TK can represent a potential predictor of clinical outcome in TBI patients.

中文翻译：

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脑外伤后血清组织激肽释放酶水平的测定

背景

组织激肽释放酶（TK）在激肽释放酶激肽系统中起重要作用。在创伤性脑损伤（TBI）中已证明了其保护作用。除了TBI的临床结果外，我们试图确定血清TK水平与创伤严重程度之间的关系。

方法

我们招募了112例重度TBI（格拉斯哥昏迷量表评分<9）和112例对照的患者。我们配置了2个多元模型来评估血清TK水平与30天死亡之间的关系。根据受试者工作特征曲线分析其预后预测能力。

结果

患者的TK水平显着低于对照组（中位数0.148 mg / l，上-下四分位数0.121-0.185，中位数0.258 mg / l，上-下四分位数0.207-0.342，P  <0.001）。TK水平与格拉斯哥昏迷量表评分密切相关（r  = 0.550）。TK水平<0.148 mg / l独立预测30天死亡率，优势比值为4.752（95％置信区间（CI），1.166–19.367）和30天总体存活率，危险比值为3.698（95％CI，1.026） –13.333）。传统知识水平显着地区分了30天死亡率，曲线下面积为0.822（95％CI，0.738-0.887）。

结论

血清TK可以代表TBI患者临床预后的潜在预测指标。