Plasma matrix metalloproteinase-9 levels predict intensive care unit mortality early after severe traumatic brain injury.
OBJECTIVES
Matrix metalloproteinase-9 (MMP-9) is an inducible metalloproteinase that can degrade the cerebrovascular matrix leading to disruption of the blood-brain barrier and exacerbation of oedema in neurotrauma. Therefore, our aim was to determine whether MMP-9 plasma levels were associated with intensive care unit (ICU) mortality after severe traumatic brain injury (TBI) despite the presence of extracerebral injuries.


METHODS
This cohort enrolled 80 patients who suffered severe TBI (Glasgow Coma Scale: 3-8 at hospital admission). The plasma MMP-9 level was determined by enzyme-linked immunosorbent assay assay at ICU admission.


RESULTS
Severe TBI was associated with a 32.5% ICU mortality rate. There was no association between the presence of extracerebral injuries (72.5% of the patients) and ICU mortality (P = 0.419). Higher plasma MMP-9 concentrations were associated with fatal outcome: 181.1 ± 16.0 ng/mL for survivors and 257.0 ± 23.2 ng/mL for nonsurvivors (mean ± S.E.M., P = 0.009). In contrast, there was no significant difference between MMP-9 levels and associated lesions: 220.8 ± 26.3 ng/mL for isolated TBI and 196.8 ± 15.8 ng/mL for patients with extracerebral injuries (P = 0.397).


CONCLUSION
Increased plasma MMP-9 levels predicted short-term fatal outcome following severe TBI, regardless the presence of extracerebral injuries.
['Simon|Daniel|D|', 'Evaldt|Joice|J|', 'Nabinger|Débora Dreher|DD|', 'Fontana|Mariano Feraboli|MF|', 'Klein|Mirelli Gabardo|MG|', 'do Amaral Gomes|Julia|J|', 'Regner|Andrea|A|']
D000293:Adolescent D000328:Adult D000070642:Brain Injuries, Traumatic D002648:Child D015331:Cohort Studies D015600:Glasgow Coma Scale D006801:Humans D007362:Intensive Care Units D016015:Logistic Models D008297:Male D020780:Matrix Metalloproteinase 9 D008875:Middle Aged D011237:Predictive Value of Tests D012372:ROC Curve D055815:Young Adult
MMP-9 Severe TBI outcome biomarker