ZINC SUPPLEMENTATION IS ASSOCIATED WITH IMPROVED NEUROLOGIC RECOVERY RATE AND VISCERAL PROTEIN-LEVELS OF PATIENTS WITH SEVERE CLOSED-HEAD INJURY

Sixty-eight patients were entered into a randomized, prospective, doub le-blinded controlled trial of supplemental zinc versus standard zinc therapy to study the effects of zinc supplementation on neurologic rec overy and nutritional/metabolic status after severe closed head injury . One month after injury, the mortality rates in the standard zinc gro up and the zinc-supplemented group were 26 and 12%, respectively. Glas gow Coma Scale (GCS) scores of the zinc-supplemented group exceeded th e adjusted mean GCS score of the standard group at day 28 (p = 0.03). Mean motor GCS score levels of the zinc-supplemented group were signif icantly higher on days 15 and 21 than those of the control group (p = 0.005, p = 0.02). This trend continued on day 28 of the study (p = 0.0 9). The groups did not differ in serum zinc concentration, weight, ene rgy expenditure, or total urinary nitrogen excretion after hospital ad mission. Mean 24-h urine zinc levels were significantly higher in the zinc-supplemented group at days 2 (p = 0.0001) and 10 (p = 0.01) after injury. Mean serum prealbumin concentrations were significantly highe r in the zinc-supplemented group (p = 0.003) at 3 weeks after injury. A similar pattern was found for mean serum retinol binding protein lev el (p = 0.01). A significantly larger number of patients in the standa rd zinc group had craniotomies for evacuation of hematoma; thus a bias may have been present. The results of this study indicate that zinc s upplementation during the immediate postinjury period is associated wi th improved rate of neurologic recovery and visceral protein concentra tions for patients with severe closed head injury.