Serum Albumin and Prealbumin Predict the Poor Outcome of Traumatic Brain Injury

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.

Serial estimation of serum albumin and its role in traumatic brain injury patients

“…Both factors were emerging as independent predictors for of TBI at 6 months. The our fi ndings are comparable with Dhandapani SS et al 11 Bernard F, et al 6 and Du Chen, et al 8 Yurchenco PD et al 20 studies was explaining different mechanisms for the decline of serum albumin in patients with TBI. Firstly, albumin consumption is increased under stress state.…”

“…Eventually, the risk of poor prognosis is signifi cantly increasing. 6,8 Results of our study give this a further confi rmation as in our study ( Figure 1e) In the analysis of all patients, in our study (Table 3a & b) after adjustment for the effects of age, GCS both univariate and multivariate logistic regressions model determined serum albumin less than 3.5 g/dl and severity of GCS was found to be highly signifi cantly, associated with unfavorable outcome. Both factors were emerging as independent predictors for of TBI at 6 months.…”

“…In the present study (Table 1c) 25% severe and 75% mild to moderate head injury patients were included and the sample size was comparable with study of Du Chen, et al 8 Dhandapani SS et al 9 and Bernard F, et al 6 were recorded serum albumin levels until day 21 after head injury. Young et al 10 noted hypoalbuminemia to last for at least 3 weeks following traumatic brain injury.…”

Lactate Albumin Ratio is Associated with Mortality in Patients with Moderate to Severe Traumatic Brain Injury

“…The causes of hypoalbuminemia after TBI is diversi ed including initial blood loss due to injury, consumption by secondary oxidative stress injury and physiological hypoalbuminemia resulted from massive crystal liquid infusion. The reduction of serum albumin and its association with mortality after TBI have been con rmed in previous studies [46][47][48][49]. The correlation between hypoalbuminemia and poor outcome of TBI patients could be explained by the brain edema and subsequent increased intracranial pressure resulted from insu cient intravascular osmolality.…”

Assessment of preoperative and postoperative prealbumin in thoracic surgery – a two months experience in a Romanian university hospital / Evaluarea preoperatorie şi postoperatorie a prealbuminei în chirurgia toracică - experiența de 2 luni a unui spital universitar din România

“…These include orthopaedics, abdominal surgery, head and neck surgery, neurosurgery, where poor nutritional status leads to a higher risk of infection, increased rate of failure of surgery or worsen the long-term outcome. The methods used for detecting patients at risk included serologic parameters, especially the use of prealbumin, clinical measurements, including hand-grip or nutritional risk scores (3)(4)(5)(6)(7).…”