C-reactive protein-albumin ratio and procalcitonin in predicting intensive care unit mortality in traumatic brain injury

Background: 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 pro-tein-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. Methods: Adults with TBI were enrolled in our study. The medical records of 82 isolated TBI pa-tients were reviewed retrospectively. Results: 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 er-ror for PCT and 0.642 with 0.066 standard error for CAR. The PCT showed a similar AUC of the re-ceiver operating characteristic to CAR. Conclusions: 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 prepa-ration of the family for the treatment process and to manage their outcome expectations.