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Independent impact of plasma homocysteine levels on neurological outcome following head injury

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Abstract

Homocysteine (tHcy) has been hardly studied among patients with head injury. This study was to evaluate whether there is any independent impact of tHcy levels on neurological outcome following head injury in a multivariate model. Patients admitted within 24 h of injury were included in the study, along with 20 age- and gender-matched controls. Plasma levels of tHcy were measured at admission using direct immunoassay. All the variables were analyzed with respect to tHcy levels and outcome according to Glasgow Outcome Score (GOS) at 3 months. Univariate and multivariate analyses were performed using SPSS 21. There were a total of 72 patients in the study. tHcy levels were significantly higher after head injury (mean 24.03[SD ± 16.0] μmol/L), compared to matched controls (mean 16.62 [SD ± 10.4] μmol/L) (p = 0.05). Patients with severe head injury, acute SDH, or diffuse higher radiological grades had greater levels of tHcy compared to others. There was a significant relationship between tHcy level and neurological outcome. tHcy levels were significantly higher in patients who had unfavorable GOS (mean 36.22[±25.3] μmol/L), compared to those with favorable GOS (mean 22.71[±14.3] μmol/L) (P = 0.03). In multivariate analysis, tHcy level (adj. odds ratio [OR] 1.17, P = 0.05) and Glasgow Coma Scale (adj. OR 5.17, P = 0.01) had significant association with neurological outcome at 3 months independent of age, dietary habit, radiological grading and of each other. tHcy level has significant independent impact on neurological outcome and may be useful as a prognostic marker following head injury.

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Authors and Affiliations

  1. Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh-12, India

    Sivashanmugam Dhandapani, Ankur Bajaj, Chandrasekar Gendle & Sunil K. Gupta

  2. NINE, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh-12, India

    Inderjeet Saini, Irwanjeet Kaur, Isha Chaudhary,  Jasandeep, Jaspinder Kaur, Geetanjali Kalyan & Manju Dhandapani

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  1. Sivashanmugam Dhandapani
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  2. Ankur Bajaj
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  3. Chandrasekar Gendle
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  4. Inderjeet Saini
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  7. Jasandeep
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  10. Manju Dhandapani
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Correspondence to Sivashanmugam Dhandapani.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from either patients or relatives of patients included in the study.

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Sivashanmugam Dhandapani and Ankur Bajaj both to be considered first authors

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Dhandapani, S., Bajaj, A., Gendle, C. et al. Independent impact of plasma homocysteine levels on neurological outcome following head injury. Neurosurg Rev 41, 513–517 (2018). https://doi.org/10.1007/s10143-017-0880-6

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  • DOI: https://doi.org/10.1007/s10143-017-0880-6

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