{"id":"0aa26749-eb69-404d-81f2-51c5632c0ba2","slug":"the-role-of-malondialdehyde-as-a-biomarker-for-predicting-adverse-outcomes-in-severe-and-moderate-traumatic-brain-injury-patients-with-subarachnoid-hemorrhage","title":"The role of malondialdehyde as a biomarker for predicting adverse outcomes in severe and moderate traumatic brain injury patients with subarachnoid hemorrhage","authors":["Nyoman Golden","Marleen Marleen","Nyoman Gde Wahyudana","Tiffany Tiffany"],"abstract":"Background: Traumatic brain injury (TBI) remains a leading cause of death and disability, particularly in younger populations, with significant clinical and socioeconomic burdens in both developed and developing countries. Despite extensive research, outcomes for TBI patients, especially those with subarachnoid hemorrhage (SAH), remain poor. Oxidative stress and ischemia, both typical sequelae of TBI, contribute to secondary brain injury, which worsens clinical outcomes. SAH exacerbates brain damage by degrading hemoglobin, forming oxyhemoglobin, and increasing oxidative stress. This cascade ultimately leads to lipid peroxidation, with malondialdehyde (MDA) as a key product. This study aims to evaluate the potential of elevated MDA levels as a prognostic biomarker for predicting poor clinical outcomes in patients with moderate-to-severe TBI complicated by SAH. Methods: This prospective cohort study included patients with moderate to severe TBI and SAH who were evaluated at RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar, Bali, Indonesia from January to June 2024. Serum MDA levels were tested at admission and classed as high or low using receiver operating characteristic (ROC) curve analysis. Additional clinical characteristics, such as demographic information and clinical condition, were also collected. Fifty-eight patients were followed for 3 months to determine clinical results, which were divided into two categories: good and poor. ROC curve analysis, descriptive statistics, proportion comparisons, and Cox regression were all performed using IBM Statistical Package for the Social Sciences version 26. Results: Patients with high MDA levels had a significantly higher mean age compared to those with low MDA levels (42.36 vs. 38.13 years). ROC analysis revealed that high MDA levels were a significant predictor of poor clinical outcomes in TBI patients with SAH, with an area under the curve of 0.714 (P = 0.0006). The relative risk for poor outcomes in patients with high MDA was 2.6 compared to those with low MDA (P = 0.004). Cox regression analysis confirmed that elevated MDA is an independent predictor of poor clinical outcomes in this patient population. Conclusion: Elevated serum MDA levels are a reliable biomarker for predicting poor clinical outcomes in patients with moderate to severe TBI complicated by SAH.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/0aa26749-eb69-404d-81f2-51c5632c0ba2/featured/hero-1781558174214.png","publishDate":"2025-11-21T00:00:00.000Z","doi":"10.25259/SNI_870_2025","categories":["Trauma","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/0aa26749-eb69-404d-81f2-51c5632c0ba2/pdf"}