Abstract
BACKGROUND: Serum neuritin and neuron-specific enolase (NSE) have predictive value for the prognosis of patients with combined traumatic brain injury (TBI) and spinal cord injury (SCI). Studying their predictive effects has positive value for disease control and treatment. METHODS: Sixty patients with combined TBI and SCI were recruited and rolled into three groups according to prognosis: Group I (n=42, favourable prognosis), Group II (n=11, poor prognosis), and Group III (n=7, death). Clinical indicators were compared between the groups, and the predictive value of different indicators for prognosis was analyzed. RESULTS: The proportion of patients with combined injuries to other organs and hypotension, as well as levels of platelets (PLT), D-dimer (D-D), antithrombin III (AT-III), S100 protein (S100), NSE, and serum neurofilament levels were significantly higher in Groups II and III compared to Group I. Conversely, the Glasgow Coma Scale (GCS) scores were significantly lower in Group I (P<0.05). Multivariable logistic regression analysis revealed that other organ injuries, GCS score, PLT, D-D, and AT-III significantly influenced the prognosis of TBI combined with SCI patients (P<0.05), while hypotension, NSE, serum neurofilament levels, S100, and accompanying organ injuries were highly correlated with the prognosis of TBI combined with SCI patients (P<0.001). The predictive sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NSE combined with serum neurofilament in predicting the prognosis of TBI combined with SCI patients were significantly higher than the singular predictive efficacy of NSE or serum neurofilament alone (P<0.05). CONCLUSIONS: To evaluate the prognosis of TBI combined with SCI patients, consideration should be given to factors such as other organ injuries, hypotension, consciousness assessment, and levels of various biomarkers. Furthermore, combined testing of serum neurofilament and NSE can more accurately predict the prognosis of TBI combined with SCI patients.