C-reactive protein to albumin ratio and Glasgow Coma Scale score as the predictors for weaning outcomes in traumatic brain injury

Abstract

Objective To identify the prognostic value of C-reactive protein to albumin ratio (CRP/ALB, CAR) and Glasgow Coma Scale (GCS) score in the weaning outcomes of mechanical ventilation (MV) in patients with traumatic brain injury (TBI).Methods Medical records of patients with TBI who were hospitalized at The Third Affiliated Hospital of Southern Medical University between January 2018 and September 2023 were collected and analysed. The patients were divided into the weaning success group and the weaning failure group. Data from the two groups were analysed to assess the predictive value of CAR and GCS score on weaning outcomes.Results CAR was an independent risk factor for weaning failure (p = .001, adjusted OR = 1.878, 95% CI: 1.283–2.750), while GCS score was a protective factor for weaning success (p = .006, adjusted OR = 0.629, 95% CI: 0.452–0.873). In the receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) of CAR predicted the weaning failure was 0.780 (p < .001), and predicted the weaning success by GCS score was 0.727 (p = .003). Moreover, the combination of the two predicted better with an AUC of 0.849 (p < .001).Conclusions TBI patients with higher CAR and lower GCS score were more likely to experience weaning failure, which can provide reliable guidance for patients with TBI to leave the ventilator.

Keywords

• Traumatic brain injury (TBI)
• acute lung injury (ALI)
• C-reactive protein to albumin ratio (CAR)
• Glasgow Coma Scale (GCS)
• mechanical ventilation (MV)