Serum periostin concentrations and outcomes after severe traumatic brain injury

Background: Periostin, a neurite outgrowth-promoting factor, is increasingly expressed in rat brain tissues after cerebral ischemia or subarachnoid hemorrhage. However, periostin concentrations are undetermined in peripheral blood from patients with traumatic brain injury (TBI). Methods: In this prospective, observational study, serum periostin concentrations were measured in 130 controls and 130 severe TBI patients. We investigated its association with trauma severity reflected by Glasgow Coma Scale (GCS) score and prognosis (i.e., 30-day mortality and 30-day overall survival). Results: As compared with the controls, serum periostin concentrations were significantly increased in the patients [(median, 246.5 ng/ml; interquartile range, 164.5-328.6 ng/ml) vs. (median, 61.8 ng/ml; interquartile range, 37.9-77.9 ng/ml), P < 0.001]. Periostin concentrations independently correlated with GCS scores (t = -6.199, P < 0.001). Serum periostin concentrations higher than 308.2 ng/ml predicted 30-day mortality with a sensitivity of 72.4% and a specificity of 78.2% [area under curve, 815; 95% confidence interval (CI), 0.737-0.878]. Periostin concentrations higher than 246.5 ng/ml were independently related to 30-day mortality and 30-day overall survival with odds ratio value of 3.829 (95% CI, 1.104-13.281) and hazard ratio value of 5.667 (95% CI, 1.953-16.443) respectively. Conclusions: Increased serum periostin concentrations clearly reflect trauma severity and mortality following TBI.