Serum Neuroglobin in Acute Traumatic Brain Injury in Children: A Multicenter Case-Control Study

Abstract

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) represents a significant cause of morbidity and mortality in children. This study aimed to delineate the temporal profile of serum neuroglobin in children after TBI and to evaluate its utility as a potential biomarker for assessing TBI severity and predicting clinical outcomes in pediatric age groups. METHODS: A multicenter case-control study was conducted involving 110 children with TBI (≤18 years) admitted to 5 tertiary-care hospitals in Egypt. The study included 100 healthy children as a control group. Serum neuroglobin concentrations were measured using enzyme-linked immunosorbent assay at 3 time points: on admission and at 24 and 72 hours thereafter. The temporal kinetics of serum neuroglobin were analyzed in relation to admission Glasgow Coma Scale scores and clinical outcomes assessed 6 months after trauma using the Glasgow Outcome Scale. RESULTS: Serum neuroglobin levels were significantly higher in children with TBI than in controls at admission (P < .001), reached the highest levels at 24 hours postinjury (P < .001), and then declined by 72 hours. Peak serum neuroglobin showed a significant inverse correlation with Glasgow Coma Scale scores (P < .0001), indicating higher levels in more severe injuries. Receiver operating characteristic analysis revealed that peak neuroglobin is a strong predictor of poor outcomes, with area under the curve of 0.89. CONCLUSION: Serum neuroglobin appears to be a promising early prognostic biomarker in pediatric patients with TBI. This preliminary study supports its potential role in early risk stratification. Its rapid rise with a peak at 24 hours postinjury, together with its association with 6-month functional outcomes, supports its potential role in early risk stratification and outcome prediction.