Relationship between the Arg72Pro polymorphism of p53 and outcome for patients with traumatic brain injury.

Abstract

To determine the relationship between the Arg72Pro polymorphism of p53 and the outcome after traumatic brain injury (TBI) in humans. A prospective study was carried out in a ten-bed surgical intensive care unit (SICU) of a university hospital. The study included 90 caucasian patients who had experienced a severe TBI within the previous 24 h. The exclusion criterion was a previous deficit in the central nervous system. The main recorded outcomes were values on the Glasgow Outcome Scale (GOS) at discharge from the SICU (GOS-0) and 6 months later (GOS-6). A blood sample was taken from each patient and all samples were analyzed by an allele-specific polymerase chain reaction for detection of Arg72Pro polymorphism of p53. These polymorphisms were tested for their association with values of GOS-0 and GOS-6. A two-tailed value of p<0.05 was considered statistically significant. The frequency of the argine/argine (Arg/Arg) genotype was greater among the patients who had a bad outcome at GOS-0 (69 vs 31% in the bad-outcome group; p=0.029). A multiple logistic regression analysis showed that patients with the Arg/Arg variation had a 2.9-fold greater risk of having a bad outcome at discharge from the SICU (95% confidence interval, 1.05-8.31; p=0.039 ). There was no similar relationship with respect to GOS-6. The Arg/Arg genotype of the Arg72Pro polymorphism in p53 is associated with increased likelihood of a bad outcome at discharge from the SICU.