nutritional and metabolic biomarkers in prediction of outcomes after traumatic brain injury: a patient cohort study

Conditions: Brain Injuries, Traumatic

Summary: to identify nutritional and metabolic biomarkers that are related to the prognosis of traumatic brain injury patients, and to develop a prognosis prediction model using biomarkers study objectives: 1. establishment of a prospective registry for traumatic brain injury patients 2. identification of nutritional and metabolic biomarkers related to prognosis of traumatic brain injury patients 3. development of a prognosis prediction model using nutritional and metabolic biomarkers 4. development of identification model for high-risk population of disabilities after traumatic brain injury

study design: multicenter observational cohort study, 5 tertiary teaching hospital emergency departments in korea study period: july 2018 to december 2023 (66 months) study population: traumatic brain injury patients aged over 18. cases will be consecutive adult patients with ems-treated traumatic brain injury and transport to the 5 emergency departments of participating hospitals within 72 hours after the trauma and confirmed cerebral hemorrhage or diffuse axial injury by radiological examination. a prospective traumatic brain injury patient cohort will be developed and all survived traumatic brain injury cases will be followed at 1-month and 6-month after ed discharge by telephone. during the study period, the investigators aim to recruit a total 1,200 cases (600 cases between july 2018 and june 2020, 600 cases between march 2021 and june 2023). data collection: following data will be collected clinical data: basic demographic and clinical outcomes will be retrieved from medical records. survey data: comorbidity, symptom, result of neurologic examination, socioeconomic status (occupation, income etc) data will be collected. blood samples: the investigators aim to develop nutritional and metabolic biomarkers of traumatic brain injury. the investigators also plan to further develop traumatic brain injury biomarkers using proteomics. follow-ups: all survived traumatic brain injury cases will be followed-up at 1-month and 6-month after ed discharge and their survival, disability, and quality of life outcomes will be collected by telephone. ethics statements: all 5 hospitals participating in the study were irb approved(seoul national university hospital(irb no: 1806-078-951), smg-snu boramae medical center(irb no: 30-2018-85), kyungpook national university hospital(irb no: 2018-10-014-007), chonnam national university hospital(irb no: cnuh-2018-297), chungbuk national university hospital(irb no: 2018-09-018)). all study patients was registered in cohort after acquisition of consent.

Eligibility criteria:
inclusion criteria: * aged over 18 years old * traumatic brain injury patient transported by ems ambulance to the emergency department of the participating hospital or transporting from another hospital emergency room (ems treated traumatic brain injury) * visiting emergency department of the participating hospital within 72 hours after trauma * with confirmed intracranial damage such as cerebral hemorrhage or diffuse axial injury by imaging exclusion criteria: * people who do not consent to personal information and blood supply for research. * with penetrating brain injury * patients with known neurological disease, psychiatric disorder. * pregnant patient * patients with a terminal condition known to have no further treatment plans due to malignancy. the terminal condition had to be checked by a doctor or recorded in medical records. * patients who were transported after surgery at the other hospital.