Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated
BackgroundThe safe timing window for surgery during the acute phase of inflammation due to traumatic brain injury (TBI) has not been studied extensively. We aimed to elucidate the relationship between the timing of surgery and changes in perioperative serum levels of inflammatory cytokines and facto...
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Frontiers Media S.A.
2024-12-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1484742/full |
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| author | Hervé Monka Lekuya Hervé Monka Lekuya Stephen Cose Marjorie Nakibuule Gift Ahimbisibwe Anthony Fuller Larrey Kasereka Kamabu Emmanuel Biryabarema Geoffrey Olweny David Patrick Kateete Anthony Kirabira Fredrick Makumbi Jelle Vandersteene Edward Baert Moses Galukande Jean-Pierre Okito Kalala |
| author_facet | Hervé Monka Lekuya Hervé Monka Lekuya Stephen Cose Marjorie Nakibuule Gift Ahimbisibwe Anthony Fuller Larrey Kasereka Kamabu Emmanuel Biryabarema Geoffrey Olweny David Patrick Kateete Anthony Kirabira Fredrick Makumbi Jelle Vandersteene Edward Baert Moses Galukande Jean-Pierre Okito Kalala |
| author_sort | Hervé Monka Lekuya |
| collection | DOAJ |
| description | BackgroundThe safe timing window for surgery during the acute phase of inflammation due to traumatic brain injury (TBI) has not been studied extensively. We aimed to elucidate the relationship between the timing of surgery and changes in perioperative serum levels of inflammatory cytokines and factors associated to optimize TBI management in low-middle-income countries.MethodsA prospective cohort study was conducted among TBI Patients with depressed skull fractures with a GCS > 8 operated at different timing from injury and followed up peri-operatively. We collected the clinical-radiological data, as well as pre-and postoperative venous samples from participants; we then did Luminex Assay to quantify the serum levels of pro/anti-inflammatory cytokines using the kits of 96-well human cytokine “27-Plex-Assay (#M500KCAF0Y®).” We performed the analysis with STATA version 17 and R_studio applying both descriptive and inferential methods.ResultsWe enrolled 82 TBI patients with a median (IQR) age of 25.5 (20–34) years, and the majority were male (85.4%). There were 48.8% victims of assaults, and 73.2% had a post-resuscitation admission GCS of 14–15. There were 38 (46.3%) who were operated within 48 h of injury versus 44 (53.7%) after 48 h. Serum levels of TNF-α were significantly higher after surgeries done >48 h compared to those done ≤48 h (p = 0.0327); whereas, the difference in post-operative mean serum levels of IL-10 was significantly increased in patients who developed later SSI compared to those who did not (11.56 versus −0.58 pg./mL, p = 0.0489). In multivariate analysis, the history of post-traumatic seizure (PTS) was associated with a postoperative increase in TNF-α (p = 0.01), the hemoglobin of 10–12 with a postoperative decrease of IL-4 (p = 0.05); the presence of focal neurological deficit was associated with a significant postoperative increased of TNF-α, IL-6, and IL-4 (p = 0.05). The presence of extra-axial hemorrhage was associated with a postoperative increase of IL-10 (p = 0.05).ConclusionDelayed surgical intervention beyond 48 h post-injury in mild–moderate TBI patients results in a significantly increased postoperative inflammatory response, as evidenced by elevated serum levels of TNF-α and IL-6. Neurological deficits, PTS, reduced hemoglobin rate, and extra-axial intracranial hemorrhage are factors associated with this heightened response. |
| format | Article |
| id | doaj-art-80afd2c40a9f42ccab892f0601b23452 |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-80afd2c40a9f42ccab892f0601b234522025-08-20T01:57:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-12-011510.3389/fneur.2024.14847421484742Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associatedHervé Monka Lekuya0Hervé Monka Lekuya1Stephen Cose2Marjorie Nakibuule3Gift Ahimbisibwe4Anthony Fuller5Larrey Kasereka Kamabu6Emmanuel Biryabarema7Geoffrey Olweny8David Patrick Kateete9Anthony Kirabira10Fredrick Makumbi11Jelle Vandersteene12Edward Baert13Moses Galukande14Jean-Pierre Okito Kalala15Department of Surgery, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Human Repair, Neurosurgery, Ghent University, Ghent, BelgiumMedical Research Council, London School of Hygiene and Tropical Medicine, Immunology, Entebbe, UgandaMedical Research Council, London School of Hygiene and Tropical Medicine, Immunology, Entebbe, UgandaMedical Research Council, London School of Hygiene and Tropical Medicine, Immunology, Entebbe, UgandaDuke Global Neurology and Neurosurgery, Duke University, Durham, NC, United StatesDepartment of Human Repair, Neurosurgery, Ghent University, Ghent, BelgiumDepartment of Molecular Biology, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Molecular Biology, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Molecular Biology, College of Health Sciences, Makerere University, Kampala, UgandaSchool of Public Health, College of Health Sciences, Makerere University, Kampala, UgandaSchool of Public Health, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Human Repair, Neurosurgery, Ghent University, Ghent, BelgiumDepartment of Human Repair, Neurosurgery, Ghent University, Ghent, BelgiumDepartment of Surgery, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Human Repair, Neurosurgery, Ghent University, Ghent, BelgiumBackgroundThe safe timing window for surgery during the acute phase of inflammation due to traumatic brain injury (TBI) has not been studied extensively. We aimed to elucidate the relationship between the timing of surgery and changes in perioperative serum levels of inflammatory cytokines and factors associated to optimize TBI management in low-middle-income countries.MethodsA prospective cohort study was conducted among TBI Patients with depressed skull fractures with a GCS > 8 operated at different timing from injury and followed up peri-operatively. We collected the clinical-radiological data, as well as pre-and postoperative venous samples from participants; we then did Luminex Assay to quantify the serum levels of pro/anti-inflammatory cytokines using the kits of 96-well human cytokine “27-Plex-Assay (#M500KCAF0Y®).” We performed the analysis with STATA version 17 and R_studio applying both descriptive and inferential methods.ResultsWe enrolled 82 TBI patients with a median (IQR) age of 25.5 (20–34) years, and the majority were male (85.4%). There were 48.8% victims of assaults, and 73.2% had a post-resuscitation admission GCS of 14–15. There were 38 (46.3%) who were operated within 48 h of injury versus 44 (53.7%) after 48 h. Serum levels of TNF-α were significantly higher after surgeries done >48 h compared to those done ≤48 h (p = 0.0327); whereas, the difference in post-operative mean serum levels of IL-10 was significantly increased in patients who developed later SSI compared to those who did not (11.56 versus −0.58 pg./mL, p = 0.0489). In multivariate analysis, the history of post-traumatic seizure (PTS) was associated with a postoperative increase in TNF-α (p = 0.01), the hemoglobin of 10–12 with a postoperative decrease of IL-4 (p = 0.05); the presence of focal neurological deficit was associated with a significant postoperative increased of TNF-α, IL-6, and IL-4 (p = 0.05). The presence of extra-axial hemorrhage was associated with a postoperative increase of IL-10 (p = 0.05).ConclusionDelayed surgical intervention beyond 48 h post-injury in mild–moderate TBI patients results in a significantly increased postoperative inflammatory response, as evidenced by elevated serum levels of TNF-α and IL-6. Neurological deficits, PTS, reduced hemoglobin rate, and extra-axial intracranial hemorrhage are factors associated with this heightened response.https://www.frontiersin.org/articles/10.3389/fneur.2024.1484742/fullneuro-inflammationperioperative serum levels inflammatory cytokinessystemic inflammatory responsetiming of surgerytraumatic brain injury |
| spellingShingle | Hervé Monka Lekuya Hervé Monka Lekuya Stephen Cose Marjorie Nakibuule Gift Ahimbisibwe Anthony Fuller Larrey Kasereka Kamabu Emmanuel Biryabarema Geoffrey Olweny David Patrick Kateete Anthony Kirabira Fredrick Makumbi Jelle Vandersteene Edward Baert Moses Galukande Jean-Pierre Okito Kalala Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated Frontiers in Neurology neuro-inflammation perioperative serum levels inflammatory cytokines systemic inflammatory response timing of surgery traumatic brain injury |
| title | Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated |
| title_full | Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated |
| title_fullStr | Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated |
| title_full_unstemmed | Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated |
| title_short | Changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild–moderate traumatic brain injury patients and factors associated |
| title_sort | changes in serum concentration of perioperative inflammatory cytokines following the timing of surgery among mild moderate traumatic brain injury patients and factors associated |
| topic | neuro-inflammation perioperative serum levels inflammatory cytokines systemic inflammatory response timing of surgery traumatic brain injury |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1484742/full |
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