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APOE epsilon 4 positive patients suffering severe traumatic head injury are more prone to undergo decompressive hemicraniectomy
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience. Univ Hosp Orebro, Sect Neurosurg, Dept Anesthesia & Intens Care, Orebro, Sweden.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
2017 (English)In: Journal of clinical neuroscience, ISSN 0967-5868, E-ISSN 1532-2653, Vol. 42, 139-142 p.Article in journal (Refereed) Published
Abstract [en]

Object: In this paper we tested the hypothesis if patients with severe traumatic brain injury and presence of the apolipoprotein E (APOE) epsilon 4 allele are more prone to undergo the surgical procedure decompressive hemicraniectomy (DC) in order to bring the intracranial pressure (ICP) under control. Methods: In this prospective consecutive study patients with sTBI were enrolled (n = 48). Inclusion criteria were arrival to our level one trauma university hospital within 24 h after trauma, patient age between 15 and 70 years, Glasgow Coma Scale (GCS) score <= 8 at the time of intubation and sedation, an initial cerebral perfusion pressure >10 mm Hg. Venous blood was sampled for APOE genotype determination. Clinical outcome at 6 months after injury was assessed with the Extended Glasgow Outcome Scale (GOSE). All surgical procedures needed for each patient were registered. Results: Patients with the APOE epsilon 4 allele were significantly overrepresented in the DC group. In the APOE epsilon 4 + DC group, ICPmax and ICPmean mean during the first 36 h were significantly higher and GOSE was significantly worse at 6 months. Conclusion: Our data suggest that patients with the APOE epsilon 4 allele are predisposed for the need of DC more often than patients without the APOE epsilon 4 allele. Thus, it seems to be of importance to consider the APOE genotype in patients suffering severe traumatic brain injury in order to forecast the need for a more exquisite intensive care. (C) 2017 Published by Elsevier Ltd.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2017. Vol. 42, 139-142 p.
Keyword [en]
Severe traumatic brain injury, APOE epsilon 4, Hemicraniectomy
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:umu:diva-138417DOI: 10.1016/j.jocn.2017.03.024ISI: 000405535800030PubMedID: 28372905OAI: oai:DiVA.org:umu-138417DiVA: diva2:1135525
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-08-23Bibliographically approved

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