Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Clin Neurol Neurosurg. 2020 Aug;195:106051. doi: 10.1016/j.clineuro.2020.106051. Epub 2020 Jun 29.
The C-reactive protein/albumin ratio (CAR), a novel inflammation-based index, has been proved useful in predicting outcome of various diseases. We designed this study to explore the prognostic value of CAR in patients with traumatic brain injury (TBI).
We retrospectively included 151 patients diagnosed with TBI and collected related clinical and laboratory data. Univariate and multivariate logistic regression were conducted to find independent risk factors of mortality. Then, we incorporated CAR into prognostic model and drew receiver operating characteristic (ROC) curve of models. Finally, we compared the predictive value of different models by evaluating the area under the receiver operating characteristic curves (AUC).
In this study, a total of 54 patients had poor survival outcome with mortality rate of 35.8 %. Results of multivariate analysis showed that GCS score in admission (OR 0.700, 95 %Cl 0.570-0.860, p=0.001), acute kidney injury (AKI) (OR 3.952, 95Cl 1.631-9.577, p=0.002) and CAR (OR 1.202, 95Cl 1.039-1.390, p=0.013) were independently associated with in-hospital mortality. The AUC value of predictive model composed of the above three factors was higher than GCS or CAR alone.
CAR is an independent risk factor of mortality in patients with TBI. Incorporating CAR into predictive model could increase the value in predicting outcome of TBI patients.
C 反应蛋白/白蛋白比值（CAR）是一种新的炎症标志物，已被证明可用于预测多种疾病的预后。我们设计本研究旨在探讨 CAR 在创伤性脑损伤（TBI）患者中的预后价值。
我们回顾性纳入了 151 例诊断为 TBI 的患者，并收集了相关的临床和实验室数据。采用单因素和多因素逻辑回归分析确定死亡率的独立危险因素。然后，我们将 CAR 纳入预后模型，并绘制模型的受试者工作特征（ROC）曲线。最后，通过评估接受者操作特征曲线下的面积（AUC）来比较不同模型的预测价值。
本研究共有 54 例患者预后不良，死亡率为 35.8%。多因素分析结果显示，入院时 GCS 评分（OR 0.700，95%Cl 0.570-0.860，p=0.001）、急性肾损伤（AKI）（OR 3.952，95Cl 1.631-9.577，p=0.002）和 CAR（OR 1.202，95Cl 1.039-1.390，p=0.013）与住院期间死亡率独立相关。由上述三个因素组成的预测模型的 AUC 值高于 GCS 或 CAR 单独预测的 AUC 值。
CAR 是 TBI 患者死亡率的独立危险因素。将 CAR 纳入预测模型可提高预测 TBI 患者预后的价值。
