DOI: https://doi.org/10.22263/2312-4156.2025.4.25
A.L. Lipnitski1,2, A.V. Marochkov1,2, D.P. Markevich3, I.A. Kupreyeva1, I.M. Loika1, V.U. Dazortsava1
Analysis of serum iron levels in patients with traumatic brain injury
1Mogilev Regional Clinical Hospital, Mogilev, Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
3Mogilev Clinical Hospital of Emergency Medical Care, Mogilev, Republic of Belarus
Vestnik VGMU. 2025;24(4):25-32.
Abstract.
Decreased serum iron levels can be frequently observed in patients after traumatic brain injury.
Objectives. To investigate the dynamics of serum iron levels in patients with irreversible traumatic brain injury.
Material and methods. 107 patients with severe traumatic brain injury were included in the prospective non-randomized study. The patients were 52 (39; 60) years old; weight – 78 (70; 85) kg; 83 (77.6%) male and 24 (22.4%) female patients. Depending on the treatment outcome, 2 groups were formed: patients with a positive treatment outcome (group 1, n=56) and withan unfavorable results of intensive care (group 2, n=51), in whom the brain death was declared during treatment. In patients the serum iron levels were analyzed on the 1, 2, 3, 5, 7 and 10 days.
Results. Statistically significant differences were found between the two groups in: level of consciousness according to the Glasgow Coma Scale upon admission (12 (8; 14) points in group 1 and 5 (4; 6) points in group 2 (p<0.0001)); volume of the intracranial hematoma (76 (56; 107) ml and 150 (75; 185) ml, respectively (p=0.0057)); the volume of blood loss during surgery (293.5 (211; 505) ml and 500 (254; 750) ml, respectively (p=0.038)); severity of the condition according to the SOFA scale upon admission (3 (1; 6) points and 7.5 (6; 11) points, respectively, (p<0.0001)). No statistically significant differences in the serum iron level on the 1st and 2nd days were found: on the 1st day – 7.9 (4.1; 12.7) μmol/l in group 1 and 5.4 (2; 11.9) μmol/l in group 2 (p=0.48). On the 3rd and subsequent days of the study, statistically significant differences in the iron level between the groups of patients were observed: on the 3rd day - 5.1 (3.3; 9.8) μmol/l in group 1 and 3 (2; 4.1) μmol/l in group 2 (p=0.002).
Conclusions. Patients with the brain death have lower serum iron levels on the 3rd and subsequent days; it is associated with both greater brain damage and systemic inflammatory response syndrome, which increases significantly with brain death.
Keywords: serum iron, iron, traumatic brain injury, brain death, potential donor, organ donor.
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Submitted 25.03.2025
Accepted 22.08.2025
Information about authors:
Artur L. Lipnitski – Candidate of Medical Sciences, head of the department for coordination of taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-2556-4801, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
A.V. Marochkov – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the branch of the Chairs of Anesthesiology & Resuscitation and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-5092-8315
D.P. Markevich – Candidate of Medical Sciences, head of the anesthesiology and resuscitation department, Mogilev Clinical Emergency Hospital, https://orcid.org/0000-0002-1117-3877
I.A. Kupreeva – head of the centralized laboratory of clinical biochemistry, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0002-5745-1203
I.N. Loyko – physician of laboratory diagnostics of the centralized laboratory of clinical biochemistry, Mogilev Regional Clinical Hospital, https://orcid.org/0009-0004-7539-5032
O.V. Dozortseva – laboratory diagnostics doctor of the centralized laboratory of clinical biochemistry, Mogilev Regional Clinical Hospital, https://orcid.org/0000-0002-4059-8321
