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High blood Fas concentrations in non-survivor patients with traumatic brain injury

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Abstract

Fas is one of the main death receptors of the extrinsic pathway of apoptosis. A study has reported higher Fas expression in brain samples of non-surviving TBI patients than in survivors. The objective of our current study was to determine whether there is an association between Fas concentrations in blood and mortality of isolated TBI patients. Patients with severe TBI [< 9 points in Glasgow Coma Scale (GCS)] and isolated TBI (< 10 non-cranial aspects points on the Injury Severity Score) were included from 5 Intensive Care Units. We measured serum Fas concentrations on the day of TBI. Non-surviving (n = 23) compared to surviving patients (n = 57) had higher age (p = 0.01), lower GCS (p = 0.001), higher APACHE-II score (p < 0.001), higher ICP (p = 0.01), higher CT findings with high risk of death (p = 0.02) and higher serum Fas concentrations (p < 0.001). We found in regression analyses an association between serum Fas levels and mortality of TBI patients after controlling for CT findings, age and CGS (OR = 1.006; 95% CI 1.001–1.011; p = 0.02), and after controlling for CT findings, ICP and APACHE-II (OR = 1.007; 95% CI 1.001–1.012; p = 0.02). Thus, the most interesting and novel finding in this study is the association between high blood Fas concentrations and mortality in TBI patients.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

TBI:

Traumatic brain injury

GCS:

Glasgow Coma Scale

ISS:

Injury Severity Score

PaO2 :

Pressure of arterial oxygen

FIO2 :

Fraction of inspired oxygen

aPTT:

Activated partial thromboplastin time

APACHE II:

Acute Physiology and Chronic Health Evaluation

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Acknowledgements

This study was supported by a grant from Instituto de Salud Carlos III (PI-18-00500) (Madrid, Spain) and co-financed with Fondo Europeo de Desarrollo Regional (FEDER). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding

This study was supported by a grant from Instituto de Salud Carlos III (PI-18–00500) (Madrid, Spain) and co-financed with Fondo Europeo de Desarrollo Regional (FEDER).

Author information

Authors and Affiliations

  1. Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320, Santa Cruz de Tenerife, Tenerife, Spain

    Leonardo Lorente

  2. Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, 38010, Santa Cruz de Tenerife, Spain

    María M. Martín

  3. Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320, Santa Cruz de Tenerife, Tenerife, Spain

    Antonia Pérez-Cejas, Carmen Ferrer-Moure & Agustín F. González-Rivero

  4. Intensive Care Unit, Hospital General de La Palma, Buenavista de Arriba s/n, 38713, Breña Alta, La Palma, Spain

    Luis Ramos-Gómez

  5. Intensive Care Unit, Hospital Universitario Dr. Negrín, CIBERES, Barranco de la Ballena S/N, 35010, Las Palmas de Gran Canaria, Spain

    Jordi Solé-Violán

  6. Universidad Fernando Pessoa Canarias, Calle la Juventud, s/n, 35450, Las Palmas de Gran Canaria, Spain

    Jordi Solé-Violán

  7. Intensive Care Unit, Hospital Insular, Plaza Dr, Pasteur s/n, 35016, Las Palmas de Gran Canaria, Spain

    Juan J. Cáceres

  8. Research Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320, Santa Cruz de Tenerife, Spain

    Alejandro Jiménez

Authors
  1. Leonardo Lorente
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  2. María M. Martín
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  3. Antonia Pérez-Cejas
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  4. Carmen Ferrer-Moure
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  5. Luis Ramos-Gómez
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  6. Jordi Solé-Violán
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  7. Juan J. Cáceres
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  8. Alejandro Jiménez
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  9. Agustín F. González-Rivero
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Contributions

LL conceived, designed and coordinated the study, participated in acquisition of data, and drafted the manuscript. MMM, LRG, JSV and JJC participated in acquisition of data and provided useful suggestions. APC, CFM and AFGR carried out serum Fas levels determinations and provided useful suggestions. AJ interpreted the data and provided useful suggestions. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Leonardo Lorente.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Institutional Board of the 5 Spanish hospitals that participated in this observational and prospective study approved the protocol study: H. General of La Palma, H. Universitario de Canarias of La Laguna, H. Insular of Las Palmas de Gran Canaria, H. Universitario Nuestra Señora de Candelaria of Santa Cruz de Tenerife and H. Universitario Dr. Negrín of Las Palmas de Gran Canaria.

Statement of human and animal rights

We obtained the Ethic Committee approval from all participating hospitals.

Informed consent

A signed informed consent by a family member of each patient was obtained.

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Lorente, L., Martín, M.M., Pérez-Cejas, A. et al. High blood Fas concentrations in non-survivor patients with traumatic brain injury. Intern Emerg Med 17, 2113–2118 (2022). https://doi.org/10.1007/s11739-022-03023-8

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  • DOI: https://doi.org/10.1007/s11739-022-03023-8

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