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Effect of apolipoprotein E genotype on hematoma volume after trauma

Effect of apolipoprotein E genotype on hematoma volume after trauma
Effect of apolipoprotein E genotype on hematoma volume after trauma
Object: the apolipoprotein E-epsilon4 (APOE-epsilon4) allele is associated with poor outcome after head injury and spontaneous intracerebral hemorrhage (SICH). The aims of this study were to determine if patients in whom one or more APOE-epsilon4 alleles are present are more likely to sustain intracranial mass lesions after head injury and to determine whether there is an isoform-specific effect on the size of the intracranial hematoma.
Methods: the authors performed a computerized volumetric analysis of 142 hematomas visible on computerized tomography (CT) scans obtained in 129 patients. The APOE genotype was determined by subjecting buccal smear samples to polymerase chain reaction and restriction enzyme digestion.
Allele frequencies were similar in head-injured patients with and without intracranial hematomas (p = 0.36). Univariate analysis revealed that in those patients with one or more APOE-epsilon4 alleles hematoma volume was greater (cube root-transformed values) than that found in patients without the APOE-epsilon4 allele (3.1 cm compared with 2.5 cm, p = 0.0039). The results of univariate analysis also suggested significant effects of patient age, injury severity (mild, moderate, or severe according to admission Glasgow Coma Scale scores) and hematoma location (extraaxial, intraaxial, or both) on hematoma volume. The mechanism of injury (assault, fall, or other) was marginally associated with hematoma volume (p = 0.052). Time from injury to CT scan, hypoxia, and hypotension had no significant effect on hematoma volume. The results of multiple linear regression analysis showed that the presence of an APOE-epsilon4 allele and an extraaxial hematoma location were independent predictors of hematoma volume, after adjusting for patient age, hours between injury and CT scan, injury severity, and injury mechanism.
Conclusions: larger hematomas were found in head-injured patients with one or more APOE-epsilon4 alleles than in patients without the allele. This may contribute to the poorer outcomes observed in these patients.
apolipoprotein E, head injury, intracranial hematoma
0022-3085
90-96
Liaquat, Imran
42036c22-185e-4422-9be3-e48b78041d44
Dunn, Laurence T.
8cbc115e-b8c9-4449-98dd-af388ff545bb
Nicoll, James A.R.
88c0685f-000e-4eb7-8f72-f36b4985e8ed
Teasdale, Graham M.
84a32691-2b76-4a52-8a11-7745fa97ed51
Norrie, John D.
a27b25fc-9980-4b54-9d8a-483f24c43b08
Liaquat, Imran
42036c22-185e-4422-9be3-e48b78041d44
Dunn, Laurence T.
8cbc115e-b8c9-4449-98dd-af388ff545bb
Nicoll, James A.R.
88c0685f-000e-4eb7-8f72-f36b4985e8ed
Teasdale, Graham M.
84a32691-2b76-4a52-8a11-7745fa97ed51
Norrie, John D.
a27b25fc-9980-4b54-9d8a-483f24c43b08

Liaquat, Imran, Dunn, Laurence T., Nicoll, James A.R., Teasdale, Graham M. and Norrie, John D. (2002) Effect of apolipoprotein E genotype on hematoma volume after trauma. Journal of Neurosurgery, 96 (1), 90-96.

Record type: Article

Abstract

Object: the apolipoprotein E-epsilon4 (APOE-epsilon4) allele is associated with poor outcome after head injury and spontaneous intracerebral hemorrhage (SICH). The aims of this study were to determine if patients in whom one or more APOE-epsilon4 alleles are present are more likely to sustain intracranial mass lesions after head injury and to determine whether there is an isoform-specific effect on the size of the intracranial hematoma.
Methods: the authors performed a computerized volumetric analysis of 142 hematomas visible on computerized tomography (CT) scans obtained in 129 patients. The APOE genotype was determined by subjecting buccal smear samples to polymerase chain reaction and restriction enzyme digestion.
Allele frequencies were similar in head-injured patients with and without intracranial hematomas (p = 0.36). Univariate analysis revealed that in those patients with one or more APOE-epsilon4 alleles hematoma volume was greater (cube root-transformed values) than that found in patients without the APOE-epsilon4 allele (3.1 cm compared with 2.5 cm, p = 0.0039). The results of univariate analysis also suggested significant effects of patient age, injury severity (mild, moderate, or severe according to admission Glasgow Coma Scale scores) and hematoma location (extraaxial, intraaxial, or both) on hematoma volume. The mechanism of injury (assault, fall, or other) was marginally associated with hematoma volume (p = 0.052). Time from injury to CT scan, hypoxia, and hypotension had no significant effect on hematoma volume. The results of multiple linear regression analysis showed that the presence of an APOE-epsilon4 allele and an extraaxial hematoma location were independent predictors of hematoma volume, after adjusting for patient age, hours between injury and CT scan, injury severity, and injury mechanism.
Conclusions: larger hematomas were found in head-injured patients with one or more APOE-epsilon4 alleles than in patients without the allele. This may contribute to the poorer outcomes observed in these patients.

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More information

Published date: 2002
Keywords: apolipoprotein E, head injury, intracranial hematoma

Identifiers

Local EPrints ID: 27640
URI: http://eprints.soton.ac.uk/id/eprint/27640
ISSN: 0022-3085
PURE UUID: adea45ca-8a77-4ef3-9a97-e777656d4ee3
ORCID for James A.R. Nicoll: ORCID iD orcid.org/0000-0002-9444-7246

Catalogue record

Date deposited: 25 Apr 2006
Last modified: 08 Jan 2022 02:55

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Contributors

Author: Imran Liaquat
Author: Laurence T. Dunn
Author: Graham M. Teasdale
Author: John D. Norrie

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