Elevated platelet-activating factor levels predict complete brachial plexus injury: a retrospective case-control study

BACKGROUND: Objective biochemical markers for stratifying brachial plexus injury (BPI) severity remain lacking. Platelet-activating factor (PAF), an inflammatory mediator implicated in neurological damage, has not been evaluated in traumatic BPI. We investigated whether serum PAF levels predict complete injury and correlate with nerve conduction impairment. METHODS: This retrospective case-control study analyzed 102 traumatic BPI patients (43 complete, 59 incomplete) and 51 matched controls enrolled between January 2020 and December 2023. Serum PAF and nerve conduction velocities (NCV) of median, radial, and ulnar nerves were measured. Multivariable logistic regression, restricted cubic spline (RCS) modeling, and ROC analysis were performed. RESULTS: BPI patients exhibited elevated PAF versus controls (171.8±26.1 vs. 147.7±12.1 pg/mL, P