AUTHOR=Zeng Rong , Li Shaoping , Yu Jiangtao , Ma Haoli , Zhao Yan 

TITLE=Performance of plasma von Willebrand factor in acute traumatic brain injury: relations to severity, CT findings, and outcomes

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 17 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1222345

DOI=10.3389/fnins.2023.1222345

ISSN=1662-453X

ABSTRACT=Background: von Willebrand factor (VWF) has been widely recognized as a biomarker for endothelial cell activation in trauma and inflammation. Traumatic brain injury (TBI) is characterized by cerebral vascular injury and subsequent inflammation. The objective of this study was to investigate the correlation between VWF levels and clinical severity, as well as imaging abnormalities, in TBI patients. Additionally, the predictive value of VWF for patient outcomes was assessed.We conducted a prospective study to recruit acute TBI patients who were admitted to the emergency department within 24 hours. Healthy individuals from the medical examination center were recruited as the control group. The aim of this study was to compare the accuracy of VWF in discriminating TBI severity and imaging abnormalities with the Glasgow Coma Scale (GCS) and Rotterdam computed tomography (CT) score. We also analyzed the predictive value of these outcomes using the Glasgow Outcome Scale (GOS) and six-month mortality.The plasma concentration of VWF in TBI patients (84.7 ± 29.7 ng/ml) was significantly higher than in healthy individuals (40 ± 8.8 ng/ml). There was a negative correlation between VWF levels and GCS scores, as well as a positive correlation between VWF levels and Rotterdam CT scores. The area under the curve (AUC) for VWF in discriminating mild TBI was 0.76 (95% CI: 0.64, 0.88), and for predicting negative CT findings it was 0.82 (95% CI: 0.72, 0.92). Meanwhile, the AUC of VWF in predicting mortality within 6-month was 0.70 (95% CI: 0.56, 0.84), and for a GOS score lower 4 was 0.78 (95% CI:0.67, 0.88). Combining VWF with either GCS or Rotterdam CT score improved the prediction ability compared to using VWF alone.VWF levels were significantly elevated in patients with TBI compared with healthy individuals. Furthermore, VWF levels demonstrated a negative correlation with GCS scores and a positive correlation with Rotterdam CT scores. In terms of predicting mortality, VWF alone was not sufficient, but its predictive power was enhanced when combined with either the Rotterdam CT score or GCS. These findings suggest that VWF may serve as a potential biomarker in assessing the severity and prognosis of TBI patients.