Independent impact of plasma homocysteine levels on neurological outcome following head injury
- 86 Downloads
Homocysteine (tHcy) has been hardly studied among patients with head injury. This study was to evaluate whether there is any independent impact of tHcy levels on neurological outcome following head injury in a multivariate model. Patients admitted within 24 h of injury were included in the study, along with 20 age- and gender-matched controls. Plasma levels of tHcy were measured at admission using direct immunoassay. All the variables were analyzed with respect to tHcy levels and outcome according to Glasgow Outcome Score (GOS) at 3 months. Univariate and multivariate analyses were performed using SPSS 21. There were a total of 72 patients in the study. tHcy levels were significantly higher after head injury (mean 24.03[SD ± 16.0] μmol/L), compared to matched controls (mean 16.62 [SD ± 10.4] μmol/L) (p = 0.05). Patients with severe head injury, acute SDH, or diffuse higher radiological grades had greater levels of tHcy compared to others. There was a significant relationship between tHcy level and neurological outcome. tHcy levels were significantly higher in patients who had unfavorable GOS (mean 36.22[±25.3] μmol/L), compared to those with favorable GOS (mean 22.71[±14.3] μmol/L) (P = 0.03). In multivariate analysis, tHcy level (adj. odds ratio [OR] 1.17, P = 0.05) and Glasgow Coma Scale (adj. OR 5.17, P = 0.01) had significant association with neurological outcome at 3 months independent of age, dietary habit, radiological grading and of each other. tHcy level has significant independent impact on neurological outcome and may be useful as a prognostic marker following head injury.
KeywordsHead injury Homocysteine Outcome CT scan Prognosis
Compliance with ethical standards
No funding was received.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from either patients or relatives of patients included in the study.
- 1.Dhandapani SS, Manju D, Sharma BS, Mahapatra AK (2007) Clinical malnutrition in severe traumatic brain injury: factors associated and outcome at 6 months. Indian J Neurotrauma 4:35-39Google Scholar
- 2.Dhandapani S, Aggarwal A, Srinivasan A, Meena R, Gaudihalli S, Singh H, Dhandapani M, Mukherjee KK, Gupta SK (2015) Serum lipid profile spectrum and delayed cerebral ischemia following subarachnoid hemorrhage: Is there a relation? Surg Neurol Int 6(Suppl 21):S543-8Google Scholar
- 6.Dhandapani S, Goudihalli S, Mukherjee KK, Singh H, Srinivasan A, Danish M, Mahalingam S, Dhandapani M, Gupta SK, Khandelwal N, Mathuriya SN (2015) Prospective study of the correlation between admission plasma homocysteine levels and neurological outcome following subarachnoid hemorrhage: a case for the reverse epidemiology paradox? Acta Neurochir 157:399–407CrossRefPubMedGoogle Scholar
- 7.Hatefi M, Behzadi S, Dastjerdi MM, Ghahnavieh AA, Rahmani A, Mahdizadeh F, Hafezi Ahmadi MR, Asadollahi K (2017) Correlation of homocysteine with cerebral hemodynamic abnormality, endothelial dysfunction markers, and cognition impairment in patients with traumatic brain injury. World Neurosurg 97:70–79CrossRefPubMedGoogle Scholar
- 13.Dhandapani S, Singh H, Negm HM, Cohen S, Anand VK, Schwartz TH (2016) Cavernous Sinus Invasion in Pituitary Adenomas: Systematic Review and Pooled Data Meta-Analysis of Radiologic Criteria and Comparison of Endoscopic and Microscopic Surgery. World Neurosurg 96:36-46Google Scholar
- 14.Adrian H, Marten K, Salla N, Lasse V (2016) Biomarkers of traumatic brain injury: temporal changes in body fluids. eNeuro 3Google Scholar
- 15.Bogoslovsky T, Gill J, Jeromin A, Davis C, Diaz-Arrastia R (2016) Fluid biomarkers of traumatic brain injury and intended context of use. Diagnostics (Basel, Switzerland) 6Google Scholar
- 18.Skovierova H, Vidomanova E, Mahmood S, Sopkova J, Drgova A, Cervenova T, Halasova E, Lehotsky J (2016) The molecular and cellular effect of Homocysteine metabolism imbalance on human health. International journal of molecular sciences 17Google Scholar
- 24.Srinivasan A, Aggarwal A, Gaudihalli S, Mohanty M, Dhandapani M, Singh H, Mukherjee KK, Dhandapani S (2016) Impact of Early Leukocytosis and Elevated High-Sensitivity C-Reactive Protein on Delayed Cerebral Ischemia and Neurologic Outcome After Subarachnoid Hemorrhage. World Neurosurg 90:91-5Google Scholar