C-reactive protein as a predictor of brain death in patients with traumatic brain injury

Abstract

Objective. To study the predictive power of the C-reactive protein (CRP) level in intensive care of patients with severe traumatic brain injury in terms of brain death.
Materials and methods. The prospective non-randomized single-center study included 82 patients with severe traumatic brain injury who were treated in the anesthesiology and intensive care units. Depending on the outcome of the received severe traumatic brain injury and intensive care, two groups of patients were formed: group 1 (n = 35) — patients discharged from the hospital; group 2 (n = 47) — patients who were diagnosed with brain death.
Results. The CRP level on the 1st and 2nd days of intensive care in the group of surviving patients and patients with brain death did not differ statistically significantly. On day 3, a statistically significant difference was noted between the patient groups in the CRP level: 104.4 [25.9; 169.9] mg/l in group 1 and 185.2 [104.2; 257.4] mg/l in group 2 (p = 0.03). On day 5, the CRP level was: 71.7 [32.6; 107.2] mg/l in group 1 and 170.5 [111.9; 256.0] mg/l in group 2 (p = 0.0006). On day 7 — 22.9 [4.9; 124.1] mg/l in group 1 and 188.1 [118.4; 236.7] mg/l in group 2 (p = 0.0002). The level of CRP on day 3 (AUC = 0.706; p = 0.019), day 5 (AUC = 0.783; p = 0.028) and day 7 (AUC = 0.844; p < 0.0001) of intensive care was a strong prognostic factor in terms of the onset of brain death.
Conclusion. Analysis of the level of CRP allows predicting the onset of brain death in patients with severe traumatic brain injury.