Abstract
BackgroundSerum albumin and prealbumin are both negative acute-phase reactants, and usually at low levels in stress. We aim to determine their predictive values for poor outcome of traumatic brain injury (TBI).MethodsA total of 326 patients of TBI were enrolled and followed-up by telephone 6 months after discharge. They were divided into a favorable group (GOS: 3 to 5) and an unfavorable group (GOS: 1 to 2). Serum albumin and prealbumin were measured from vein blood within 24 h after admission.ResultsNinety one (27.9%) patients were with poor outcome (GOS: 1 to 2). The unfavorable group had lower albumin and prealbumin (P<0.001). Albumin and prealbumin were both positively correlated with GCS (r = 0.489, P<0.001; r = 0.222, P<0.001, respectively) and GOS (r = 0.518, P<0.001; r = 0.314, P<0.001, respectively). After adjustment for confounding factors, the odds ratios of albumin and prealbumin were 0.866, 95% CI: 0.829 to 0.904 and 0.990, 95% CI: 0.985 to 0.995, respectively. In subgroup of GCS≤8 (n = 101), the crude and adjusted odds ratios of serum albumin were both statistically significant (P = 0.027, P = 0.033, respectively), while prealbumin were not (P = 0.553, P = 0.576, respectively). The AUC of albumin for predicting poor outcome was 0.762, 95% CI: 0.712 to 0.807, which was significantly higher than that of prealbumin (0.664, 95% CI: 0.610 to 0.715). In analyses of all patients and subgroup of GCS≤8, the AUCs of serum albumin were both significantly higher than those of prealbumin (P = 0.001, P = 0.045, respectively).ConclusionsBoth serum albumin and prealbumin could predict the poor outcome of TBI, but the former is much better, especially, in patients with severe TBI.
Highlights
Traumatic brain injury (TBI) is a major global health problem
The aim of this study is to investigate the predictive values of serum albumin and prealbumin for the poor outcome of traumatic brain injury (TBI) through a retrospective case-control study, and make a comparison between them
In Receiver Operating Characteristic (ROC) curve analyses, the area under the curve (AUC) of serum albumin were statistically significant in both subgroups (P,0.05), while prealbumin showed no predictive value in the subgroup of Glasgow Coma Scale (GCS)#8
Summary
Traumatic brain injury (TBI) is a major global health problem. Country-based estimates of incidence range from 108 to 332 new cases admitted to hospital per 100 000 population per year. 39% of patients with severe TBI die from their injury, and 60% have an unfavorable outcome on the Glasgow Outcome Scale (GOS) [1]. According to the World Health Organization (WHO) in high-income countries TBI is the leading cause of death under the age of 40. Based on the prognosis of the WHO, in two decades, head injury will be the third most frequent cause of death in the world [2]. The socioeconomic consequences of TBI have ignited widespread research aimed at decreasing the burden of the disease. We aim to determine their predictive values for poor outcome of traumatic brain injury (TBI)
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