Background: Different apoptosis pathways activate caspase-3. In a study involving 27 patients with traumatic brain
injury (TBI), higher caspase-3 levels were found in contusion brain tissue resected from non-survivors than from
survivors. The objective of this study was to determine whether there is an association in TBI patients between
serum caspase-3 levels (thus using an easier, quicker, less expensive and less invasive procedure) and mortality, in a
larger series of patients.
Methods: We carried out a prospective, observational and multicenter study in six Spanish Hospital Intensive Care
Units including 112 patients with severe TBI. All had Glasgow Coma Scale (GCS) scores lower than 9. Patients with
an Injury Severity Score (ISS) in non-cranial aspects higher than 9 were excluded. Blood samples were collected on
day 1 of TBI to measure serum caspas-3 levels. The endpoint was 30-day mortality.