Catecholamines as Independent Predictors of Outcome in Moderate and Severe Traumatic Brain Injury (TBI). The COMA-TBI Study

Introduction: High levels of catecholamines post brain trauma are associated with severity of injury and neurological outcome. We aimed to overcome methodological limitations of previous studies and demonstrate an independent association between circulating catecholamine levels with neurological outcome in patients with isolated brain injury. Methods: Multi site, prospective observational blinded cohort study. After enrollment, patients had catecholamine levels measured on admission and the independent association with a 6-month neurological outcome was assessed using the Glasgow Outcome Scale Extended. Multivariate logistic regression models estimated the adjusted odds ratio for prediction of unfavorable outcome. Results: 181 patients were enrolled and admission catecholamines were measured. High admission levels were independently associated with severity of injury and with unfavorable outcome. Conclusion: We demonstrated the natural history of catecholamine release early post brain injury and an independent association with unfavorable outcome in a dose response fashion. Catecholamines are biomarkers of outcome in moderate to severe traumatic brain injury.M.Sc