4.6 Article

Prognostic Value of Serum Procalcitonin Based Model in Moderate to Severe Traumatic Brain Injury Patients

Journal

JOURNAL OF INFLAMMATION RESEARCH
Volume 15, Issue -, Pages 4981-4993

Publisher

DOVE MEDICAL PRESS LTD
DOI: 10.2147/JIR.S358621

Keywords

procalcitonin; traumatic brain injury; extracranial injury; prognosis

Categories

Funding

  1. 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University [2020HXFH036]
  2. Knowledge Innovation Program of the Chinese Academy of Sciences [JH2022007]
  3. General Program of the National Natural Science Foundation of China [82173175]

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Procalcitonin (PCT) serves as an efficient prognostic marker for isolated moderate-to-severe TBI patients, but not for those with extracranial injury. A prognostic model incorporating GCS, glucose, cholesterol, and PCT is valuable for early risk stratification in isolated TBI cases.
Objective: Procalcitonin (PCT) is an acknowledged marker of systemic inflammatory response. Previous studies have not reached agreement on the association between serum PCT and outcome of traumatic brain injury (TBI) patients. We designed this study to confirm the prognostic value of PCT in isolated TBI and those with extracranial injury, respectively.Methods: Patients hospitalized in our hospital for moderate-to-severe TBI between March 2015 and December 2019 were included. Logistic regression analysis was performed to validate the association between PCT and in-hospital mortality in these patients. AUC (area under the receiver operating characteristics curve) of PCT and constructed model were calculated and compared.Results: Among the included 211 patients, 81 patients suffered a poor outcome, with a mortality rate of 38.4%. Non-survivors had a higher level of serum PCT (2.73 vs 0.72, p<0.001) and lower GCS (5 vs 7, p<0.001) on admission than survivors. AUC of single PCT for predicting mortality in isolated TBI and those with extracranial injury were 0.767 and 0.553, respectively. Multivariate logistic regression showed that GCS (OR=0.744, p=0.008), glucose (OR=1.236, p<0.001), cholesterol (OR=0.526, p=0.002), and PCT (OR=1.107, p=0.022) were independently associated with mortality of isolated TBI. The AUC of the prognostic model composed of GCS, glucose, cholesterol, and PCT was 0.868 in isolated TBI.Conclusion: PCT is an efficient marker of outcome in isolated moderate-to-severe TBI but not those with extracranial injury. A prognostic model incorporating PCT is useful for clinicians to make early risk stratification for isolated TBI.

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