The predictive value of catecholamines in assessing outcome in XXXX .

@entity1 @entity131 @entity935 @entity1425 @entity772 @entity2922 @entity1063
Because of the central role of the sympathetic nervous system in mediating the stress response, plasma @entity1063 (NE), @entity1425 (E), and @entity935 (DA) levels were measured in 61 traumatically brain-injured @entity1 to determine whether @entity2922 (CA) levels obtained within 48 hours after injury provide reliable prognostic markers of outcome. @entity1 outcome was determined at 1 week using the Glasgow @entity772 Scale (GCS) and at the time of discharge using the Glasgow Outcome Scale (GOS). Levels of NE, E, and DA correlated highly with the admission GCS score (NE: r = 0.58, p less than 0.0001; E: r = 0.46, p less than 0.0025; DA: r = 0.27, p less than 0.04). Moreover, in the 21 @entity1 with GCS scores of 3 or 4 on admission, NE levels predicted outcome at 1 week. All six @entity1 with NE levels less than 900 pg/ml (normal level less than 447 pg/ml) improved to GCS scores of greater than 11, while 12 of 15 with NE values greater than 900 pg/ml remained with GCS scores of 3 to 6 or died. Levels of E and DA were not as useful. @entity2922 levels also increased significantly as the GOS score worsened. Levels of NE and E were significantly higher in @entity1 who died or remained persistently vegetative than in those with better outcomes. In the 54 @entity1 who survived beyond 1 week, significant correlations were present between the length of hospitalization and NE (r = 0.71, p less than 0.0001) and E (r = 0.61, p less than 0.0001) levels. Concentrations of NE (r = 0.61, p less than 0.0004) and E (r = 0.48, p less than 0.01) were also highly correlated with the duration of ventilatory assistance. Analysis of the interactions of CA levels and GCS scores, duration of ventilatory assistance, and length of hospitalization revealed that the CA's either enhanced the reliability of the GCS score or were independent predictors of outcome. Thus, these findings indicate that alterations in circulating CA levels reflect the severity of the neurological insult and provide support for the use of CA measurements as a physiological marker of @entity1 outcome in both the acute and chronic phases of @entity131 .
