Correlation Between Serum Homocysteine Levels and Outcome of Patients with Severe Traumatic Brain Injury

OBJECTIVE: To examine the relationship between homocysteine (Hcy) plasma levels and the outcome of patients with traumatic brain injury (TBI). METHODS: In a prospective case-control study, demographic, clinical, and Glasgow Coma Scale score data were collected. Outcome was evaluated according to the Glasgow Outcome Scale score at the time of discharge from the hospital and 6 months after hospitalization. Plasma levels of Hcy were measured using high-performance liquid chromatography. Computed tomography scan of the brain was performed within the first 24 hours of hospitalization. RESULTS: The case group comprised 150 patients with TBI (men, 54.7%; mean age, 55.90 years +/- 12.31), and a control group comprised 150 healthy individuals (men, 52%; mean age, 49.56 years +/- 15.64) were studied. The mean +/- SD plasma Hcy level in the TBI group (20.91 mmol/L +/- 15.56) was significantly higher than plasma Hcy level in the control group (7.45 mmol/L +/- 13.54, P = 0.000). There was a significant relationship between Hcy plasma levels and Glasgow Coma Scale score and computed tomography findings classified by the Marshall score. (P = 0.001 and P = 0.028, respectively). Also, there was a significant difference in mean Hcy plasma between patients who died as a result of TBI and patients who were still alive at the end of the study period according to Glasgow Outcome Scale score (P = 0.000 and P = 0.054, respectively). CONCLUSIONS: There was a significant correlation in this study between plasma Hcy levels and severity of trauma and prognosis in patients with TBI.