The value of adropin levels in determining the severity of pediatric mild traumatic brain injury in the emergency department: A prospective study

Abstract

Background & Objective: The presence of mild traumatic brain injury (mTBI) in paediatric patients poses significant challenges in terms of diagnosis, particularly with regard to determining which patients require neuroimaging procedures. Adropin, a peptide hormone with neuroprotective properties, has been proposed as a biomarker of brain injury. The present study examined the association between serum adropin levels and mTBI severity in children, with the classification of subjects based on clinical and radiological risk factors.

Methods: In this prospective study, 56 paediatric patients (aged 0–18 years) with mTBI and 57 age-matched controls were enrolled. The mTBI patients were stratified into low-, intermediate-, and high-risk categories based on clinical presentation and computed tomography (CT) findings. Serum adropin was measured using an enzyme-linked immunosorbent assay (ELISA). Group comparisons were performed with one-way analysis of variance (ANOVA) and Bonferroni post hoc tests; receiver operating characteristic (ROC) analysis was used to determine cut-off values, sensitivity, and specificity.

Results: A significant increase in mean serum adropin levels was observed in the mTBI group compared to the control group (4815.04 ± 2970.26 vs 1385.48 ± 290.50 pg/mL; p < 0.001). Within the mTBI cohort, adropin levels increased with risk status, reaching the highest levels in high-risk patients and in those with temporoparietal trauma. ROC analysis identified a cut-off of 1650.5 pg/mL to differentiate mTBI from controls (sensitivity 84%, specificity 82%) and 5520 pg/mL to distinguish high- from low-risk mTBI (sensitivity 85%, specificity 80%).

Conclusion: Serum adropin levels appear to reflect injury severity in mTBI and may aid risk stratification and imaging decisions. In order to confirm these findings and to define the role of adropin and related biomarkers, further research is required in the form of larger studies.