To determine the effects of zinc supplementation on clinical outcomes of patients with severe head trauma, this double-blind clinical trial randomly allocated 100 patients with severe head trauma, aged between 18 to 65 years, to receive placebo or 120 mg zinc via a nasogastric tube for 15 days. Plasma zinc and copper, 24-hour urinary zinc excretion, Sequential Organ Failure Assessment (SOFA) were assessed on days 1, 7, and 16. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count were measured on days 1 and 16. Glasgow outcome score (GOS), mortality rate on day 28, and length of stay (LOS) were compared between groups. There were no significant differences in baseline data between groups (all p > .05). Mean plasma zinc concentration was significantly higher in the zinc group than the placebo group on day 7 (119.5 vs. 81.7 µg/dl, p < .001) and day 16 (124.1 vs. 101.1 µg/dl, p < .001). The SOFA, GOS, and inflammation factors were significantly better in the zinc-supplemented group by day 16 (all p < .05). The LOS was shorter (52 vs. 65 days, p = .043) and mortality rate on day 28 was borderline lower (17% vs. 22%, p = .507) in zinc versus placebo groups. Zinc supplementation in the study had favorable effects on GOS, SOFA score, and inflammatory markers in patients with severe head injury.

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Our study suggested that there was no considerable difference between GCS and APACHE II scores for predicting mortality in head injury patients. Both scales showed acceptable PPV, while APACHE II showed better results. However, the utilization of GCS in the initial assessment is recommended over APACHE II as the former provides higher time- and cost-efficiency.

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