Gürsoy Canan, Gürsoy Güven, Demirbilek Semra Gümüş
Division of Intensive Care, Department of Anesthesiology and Reanimation, Muğla Sıtkı Koçman University, Menteşe/Muğla, Türkiye.
Department of Neurosurgery, Muğla Training and Research Hospital, Menteşe/Muğla, Türkiye.
Acute Crit Care. 2022 Aug;37(3):462-467. doi: 10.4266/acc.2022.00052. Epub 2022 Aug 5.
Prediction of intensive care unit (ICU) mortality in traumatic brain injury (TBI), which is a common cause of death in children and young adults, is important for injury management. Neuroinflammation is responsible for both primary and secondary brain injury, and C-reactive protein-albumin ratio (CAR) has allowed use of biomarkers such as procalcitonin (PCT) in predicting mortality. Here, we compared the performance of CAR and PCT in predicting ICU mortality in TBI.
Adults with TBI were enrolled in our study. The medical records of 82 isolated TBI patients were reviewed retrospectively.
The mean patient age was 49.0 ± 22.69 years; 59 of all patients (72%) were discharged, and 23 (28%) died. There was a statistically significant difference between PCT and CAR values according to mortality (P<0.05). The area under the curve (AUC) was 0.646 with 0.071 standard error for PCT and 0.642 with 0.066 standard error for CAR. The PCT showed a similar AUC of the receiver operating characteristic to CAR.
This study shows that CAR and PCT are usable biomarkers to predict ICU mortality in TBI. When the determined cut-off values are used to predict the course of the disease, the CAR and PCT biomarkers will provide more effective information for treatment planning and for preparation of the family for the treatment process and to manage their outcome expectations.
创伤性脑损伤（TBI）是儿童和年轻人常见的死亡原因，预测其在重症监护病房（ICU）的死亡率对于损伤管理很重要。神经炎症是原发性和继发性脑损伤的原因，而C反应蛋白-白蛋白比值（CAR）已使得降钙素原（PCT）等生物标志物可用于预测死亡率。在此，我们比较了CAR和PCT在预测TBI患者ICU死亡率方面的表现。
纳入患有TBI的成年患者进行我们的研究。回顾性分析82例单纯TBI患者的病历。
患者平均年龄为49.0±22.69岁；所有患者中有59例（72%）出院，23例（28%）死亡。根据死亡率，PCT和CAR值之间存在统计学显著差异（P<0.05）。PCT的曲线下面积（AUC）为0.646，标准误为0.071；CAR的AUC为0.642，标准误为0.066。PCT的受试者工作特征曲线的AUC与CAR相似。
本研究表明，CAR和PCT是可用于预测TBI患者ICU死亡率的生物标志物。当使用确定的临界值来预测疾病进程时，CAR和PCT生物标志物将为治疗计划、让家属为治疗过程做好准备以及管理他们的预后期望提供更有效的信息。
