Assessment of serum trace elements and its association with severity and outcome of Iraqi patients with traumatic brain injury

Alabasi, Zahraa .H; Al-Gebori, Abdulnasser .; Al-Rawi, Mohammed Ameen

doi:10.37652/juaps.2025.163517.1570

	Assessment of serum trace elements and its association with severity and outcome of Iraqi patients with traumatic brain injury
Journal of University of Anbar for Pure Science
Volume 20, Issue 2, August 2026, Pages 187-195 PDF (520.97 K)
Document Type: Research Paper
DOI: 10.37652/juaps.2025.163517.1570
Authors
Zahraa .H Alabasi^* ¹; Abdulnasser . Al-Gebori¹; Mohammed Ameen Al-Rawi²
¹Applied Sciences college , Applied Chemists department, University of Technology, Baghdad, Iraq
²Neurosurgery teaching hospital, Baghdad, Iraq
Abstract
Trace elements, such as copper and iron, play vital roles in brain metabolism and oxidative stress regulation. This study investigated the role of trace element imbalance, specifically copper and iron, in traumatic brain injury (TBI) severity, type, treatment, and patient outcomes over 3 months. A case-control study was conducted on 60 patients with TBI who were admitted to hospitals in Baghdad, Iraq, within 8 h of injury, along with 40 healthy controls. Serum samples were analyzed using colorimetric methods. Patient outcomes were assessed 3 months after injury in 31 patients. The results revealed significant differences in serum copper and iron levels between patients with TBI and healthy controls. Copper levels also differed significantly between the acute phase and 3 months after injury (p = 0.001), whereas iron levels increased but not significantly (p = 0.788). Copper levels were notably lower in patients with severe injuries than in those with moderate and mild injuries (p = 0.001). Mean copper levels were significantly lower in patients with poor outcomes than in those with good outcomes (p = 0.002). The ability of copper levels to discriminate patients with TBI was evaluated using receiver operating characteristic analysis, with an AUC of 0.242 (95% confidence interval [CI], 0.124–0.361). The optimal cutoff value was 91.65 µg/dL, with 11.4% specificity and 91.1% sensitivity. The AUC for iron was 0.342 (95% CI, 0.222–0.462). The optimal cutoff value was 92.3 µg/dL, with 79.4% specificity and 18.2% sensitivity. These findings suggest that altered copper and iron homeostasis may be associated with TBI and may reflect injury severity and patient outcomes.
Keywords
Cu; Fe; GCS; GOS; TBI; Trace elements

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