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 netirotrauma. 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 admissibM. 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 far survivors and 257.0 +/- 23.2 ng/mL for nansurvivors (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.