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Procalcitonin/Albumin Ratio Predicts the Outcome After Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis

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Abstract

Background

The procalcitonin/albumin ratio (PAR), a novel inflammation-based index, has been reported to predict the prognosis following cardiopulmonary bypass surgery and bacterial infection. However, whether PAR can predict the outcome of patients with severe traumatic brain injury (STBI) has not been fully elucidated. This study aimed to investigate the relationship between serum PAR levels and prognosis at 6 months after STBI.

Methods

We retrospectively enrolled 129 patients diagnosed with STBI and collected relevant clinical and laboratory data. Logistic regression analysis was used to estimate the association of PAR with the prognosis of STBI. The receiver operating characteristics curve was performed to examine the predictive use of PAR for prognosis. Propensity score matching (PSM) analysis was also performed to improve the reliability of the results. The primary outcome measures were expressed as a score on the modified Rankin Scale at 6 months.

Results

The unfavorable prognosis group had advanced age, lower Glasgow Coma Scale score, higher rate of cerebral hernia and intracranial infection, higher neutrophil/lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR), elevated PAR, and higher rate of pneumonia. Multivariate analysis showed that PAR (before PSM: odds ratio 3.473, 95% confidence interval 2.983–4.043, P < 0.001; after PSM: odds ratio 5.358, 95% confidence interval 3.689–6.491, P < 0.001) was independently associated with unfavorable outcome. The area under the curve of the PAR for predicting an unfavorable outcome was higher than that of the CAR and NLR.

Conclusions

The PAR might be a novel independent risk factor of the outcome after STBI. Moreover, PAR was a better biomarker in predicting the outcome of patients with STBI than CAR and NLR.

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Acknowledgements

This research was supported by the Department of Neurosurgery and intensive care unit at The Second Affiliated Hospital of Chongqing Medical University.

Funding

This work was supported by the Kuanren Talents Program of The Second Affiliated Hospital of Chongqing Medical University (No. 201959), the Venture & Innovation Support Program for Chongqing Overseas Returnees (No. CX2019156), and the Chongqing Science and Health Joint Medical Research Project (No. 2020GDRC006).

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Author notes

  1. Mingjiang Sun and Lingui Gu contributed equally to this article.

Authors and Affiliations

  1. Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, 76 Linjiang Road, Chongqing, 400010, China

    Mingjiang Sun, Yihao Tao & Zongyi Xie

  2. Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Mingjiang Sun

  3. Department of Neurosurgery, Center for Malignant Brain Tumors, National Glioma Multi-disciplinary Team Alliance, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Lingui Gu

  4. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China

    Yuanyou Li

  5. Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China

    Fushu Luo

  6. Department of Endocrinology, The First Affiliated Hospital, Chongqing Medical and Pharmaceutical College, Chongqing, China

    Weiwei Shen

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  1. Mingjiang Sun
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Contributions

MS and YL: conception and design. MS and LG: collection and assembly of data. LG and FL: data analysis and interpretation. MS and YT: manuscript writing. WS and ZX: manuscript proofread and supervision. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Zongyi Xie.

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Ethical Approval/Informed Consent

This is an observational study. The Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University has confirmed that no ethical approval is required.

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Sun, M., Gu, L., Li, Y. et al. Procalcitonin/Albumin Ratio Predicts the Outcome After Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis. Neurocrit Care 40, 664–673 (2024). https://doi.org/10.1007/s12028-023-01792-4

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  • DOI: https://doi.org/10.1007/s12028-023-01792-4

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