Plasma cortisol as a noninvasive biomarker to assess severity and prognosis of patients with craniocerebral injury.

OBJECTIVE: The aim of this work is to evaluate the usefulness of plasma cortisol levels in determining the severity and prognosis in patients with a craniocerebral injury.

PATIENTS AND METHODS: About 90 patients with craniocerebral injury and 40 control subjects were selected prospectively for the study. The plasma cortisol level was measured on 1st, 3rd, 7th and 21st day after admission into the hospital. The patients with craniocerebral injury were divided into two groups according to the Glasgow Coma Scale (GCS 3-5 and GCS 6-8), and within each group sub-groups namely Death and Survival were made based on survival status of patients.

RESULTS: The plasma cortisol levels during the 1st and 3rd days were significantly increased in both GCS 3-5 and GCS 6-8 groups in comparison with control (p < 0.01); further, the GCS 3-5 group had higher plasma cortisol levels than GCS 6-8 (p < 0.05). The plasma cortisol level during the 1st and 3rd days in Death and Survival groups were significantly higher than the control (p < 0.05). Further, during the 7th day, plasma cortisol level was significantly elevated in the Death group than Survival group (p < 0.05).

CONCLUSIONS: Since we found a significant association between plasma cortisol level and severity (Glasgow Coma Scale) and prognosis in patients with craniocerebral injury, the plasma cortisol level can be used as a non-invasive biomarker to assess the severity and prognosis in craniocerebral injury patients.