Abstract
Background: Traumatic brain injury (TBI) is a serious public health issue all over the world. This study was designed to evaluate the prognostic value of lactate to albumin ratio (LAR) on moderate to severe traumatic brain injury.Methods: Clinical data of 273 moderate to severe TBI patients hospitalized in West China Hospital between May 2015 and January 2018 were collected. Multivariate logistic regression analyses were used to explore risk factors and construct prognostic model of in-hospital mortality in this cohort. Nomogram was drawn to visualize the prognostic model. Receiver operating characteristic (ROC) curve and calibration curve were respectively drawn to evaluate discriminative ability and stability of this model.Results: Non-survivors had higher LAR than survivors (1.0870 vs 0.5286, p<0.001). Results of multivariate logistic regression analysis showed that GCS (OR=0.818, p=0.008), blood glucose (OR=1.232, p<0.001), LAR (OR=1.883, p=0.012), and red blood cell distribution (RDW)-SD (OR=1.179, p=0.004) were independent risk factors of in-hospital mortality in included patients. These four factors were utilized to construct prognostic model. The area under the ROC curve (AUC) value of single lactate and LAR were 0.733 (95%Cl; 0.673-0.794) and 0.780 (95%Cl; 0.725-0.835), respectively. The AUC value of the prognostic model was 0.868 (95%Cl; 0.826-0.909), which was higher than that of LAR (Z=2.5143, p<0.05).Conclusions: LAR is a readily available prognostic marker of moderate to severe TBI patients. Prognostic model incorporating LAR is beneficial for clinicians to evaluate possible progression and make treatment decisions in these patients.