Application of Serum NADPH Oxidase 2 Levels for Predicting 180-Day Clinical Outcomes Following Severe Traumatic Brain Injury: A Prospective Cohort Analysis

Abstract

Objectives

Nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2) affects oxidative response to acute brain injury. We set out to determine if there are connections between serum NOX2 levels, severity, and subsequent clinical outcomes of severe traumatic brain injury (sTBI).

Methods

In this prospective cohort study, serum NOX2 levels were measured in 123 patients and 123 controls. The Glasgow Coma Scale (GCS) scores and Rotterdam computed tomography (CT) classifications were applied for assessing injury severity. A poor prognosis was considered if the Glasgow Outcome Scale Extended (GOSE) score was 4 or below at 180 days post-injury.

Results

STBI patients exhibited markedly enhanced serum NOX2 levels relative to healthy controls, and serum NOX2 levels were independently linked to Rotterdam CT classifications and GCS scores. Serum NOX2 levels effectively identified individuals at risk of death or poor prognosis at 180-day after sTBI. When compared to GCS scores and Rotterdam CT classifications, its predictive power was comparable. When the three variables were utilized together, the model's predictive ability was significantly higher than when they were independently used.

Conclusions

NOX2 might be used as a potential biomarker to assess the severity of sTBI and foretell its outcome, since elevated serum NOX2 levels are significantly linked to increasing severity, 180-day mortality, and poor prognosis after sTBI.