Prediction of Initial CRP/Albumin Ratio on In-Hospital Mortality in Isolated Traumatic Brain Injury Patients

Area of Science:

• Biochemistry
• Critical Care Medicine
• Neurology

Background:

• The C-reactive protein/albumin ratio (CAR) is an established mortality predictor in intensive care unit (ICU) settings.
• Isolated traumatic brain injury (iTBI) presents a significant challenge in critical care, with in-hospital mortality (IHM) being a key outcome measure.

Purpose of the Study:

• To evaluate the predictive capability of the CAR for in-hospital mortality (IHM) specifically in patients with isolated traumatic brain injury (iTBI).

Main Methods:

• A retrospective analysis was conducted on 200 patients with iTBI admitted to a neurosurgical ICU.
• Serum biomarkers (including CRP and albumin), demographic data, radiological findings, ICU scores, and cardiopulmonary parameters were analyzed.
• Statistical methods included logistic regression and Receiver Operating Characteristic (ROC) analysis to identify independent predictors of IHM.

Main Results:

• The overall IHM rate was 27.5%.
• Independent predictors of IHM included advanced age, lower Glasgow Coma Scale (GCS) score, higher lactate levels, higher CAR, and increased norepinephrine use.
• ROC analysis identified a CAR cut-off value of >0.38 as significantly associated with IHM (Youden index 0.073, sensitivity 27.9%, specificity 64.8%, p = 0.044).

Conclusions:

• The CAR is a novel and independent predictor of in-hospital mortality in patients with isolated traumatic brain injury.
• A CAR value greater than 0.38 may aid in identifying iTBI patients at higher risk for mortality.
• Further research could explore the integration of CAR into clinical decision-making for iTBI management.