Laboratory Biomarkers of Brain Damage among Hospitalized Patients: A Systematic Review
Keywords:
Biomarkers, Ischemic Stroke, Diagnosis, Prognosis, Admission.Abstract
Introduction: This systematic review aims to explore the role of biomarkers in predicting unfavorable events associated with traumatic brain injuries and ischemic strokes. We conducted a search in PubMed, resulting in the identification of eleven potentially relevant studies.
Methods: Our search yielded a total of eleven potentially relevant studies from PubMed. After excluding three studies, as two had insufficient information and one was a review, the review included eight studies. The overall sample size across these studies ranged from 37 patients to 6,315 patients.
Results: Most of the included studies demonstrated the ability of various biomarkers to serve as prognostic indicators for predicting unfavorable outcomes in the context of ischemic or traumatic brain injuries. Higher levels of these biomarkers were associated with an increased risk of traumatic injuries or ischemic strokes. For instance, Zhong et al. identified MMP-9 as a potential prognostic factor for acute ischemic stroke, with higher serum MMP-9 levels correlating with an elevated risk of mortality and disability at three months. Similarly, Tsai et al. observed significantly higher concentrations of serum thiobarbituric acid-reactive substances (TBARS) in acute ischemic stroke patients, suggesting its potential as a predictor for three-month outcomes. Kwon et al. found that elevated serum homocysteine levels were independent predictors of acute ischemic stroke and early neurological deterioration. FABP4, copeptin, and NT-proBNP were also identified as independent prognostic markers for functional outcomes, mortality, or cardiovascular disease (CVD) in ischemic stroke patients. Conversely, lower concentrations of serum ficolin-3 were proposed as an independent prognostic biomarker for post-severe traumatic brain injury. Additionally, reduced levels of serum 25-hydroxyvitamin D (25(OH) D) were associated with increased stroke severity and poorer functional outcomes in acute ischemic stroke patients.
Conclusions: The findings from this systematic review suggest that a range of biomarkers, when assessed in patients with traumatic brain injuries and ischemic strokes, can serve as valuable prognostic tools, aiding in the prediction of unfavorable outcomes. These biomarkers may contribute to better risk assessment and patient management in these critical clinical scenarios.
