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2026, Number 4

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Med Crit 2026; 40 (4)

Comparison of the procalcitonin/albumin ratio vs inflammatory markers as predictors of mortality in head trauma

Bermúdez LC, Galves BC, García LR, Fuentes OC, Michael BMH, Adame MI

Language: Spanish
References: 37
Page: 274-280
PDF size: 691.73 Kb.


ABSTRACT

Introduction: traumatic brain injury (TBI) is currently a public health problem that has a social and clinical impact on the country. It is estimated that the incidence of 800 cases per 100,000 inhabitants worldwide, and the inflammatory mechanisms are not fully understood. A study comparing different biomarkers, such as the procalcitonin/albumin ratio, with mortality risk and other markers could lead to the early identification of new therapeutic targets. Objective: to compare the procalcitonin/albumin ratio with other inflammatory markers as predictors of mortality, such as C-reactive protein, albumin, CRP/albumin ratios, and neutrophil/lymphocyte ratios in patients with head trauma November 2024 to August 2025. Material and methods: this was a prospective, analytical, longitudinal study conducted in the Intensive Care Unit (ICU). The study included all patients with head trauma who were evaluated six hours after hospitalization or admission to the ICU with biomarkers of interest, such as C-reactive protein (CRP), albumin, CRP/albumin ratios, neutrophil/lymphocyte ratios, and procalcitonin/albumin. Regarding statistical analysis, inferential analyses will be performed using independent groups tests such as Student’s t test and Mann-Whitney U test. Class analysis will be evaluated using a χ2 test, and a p value < 0.05 will be considered significant. Results: in the study population, the majority were men with 45 (65.2%), in terms of classification or severity of TBI, both patients with severe and moderate classification reported a very similar frequency with 36 (52.2%) and 30 (43.5%); respectively. Finally, 18 (26.1%) deaths were recorded in the population. When comparing according to each of the biochemical values with respect to the patient’s discharge, it stood out that the parameters of procalcitonin, CRP, CRP/albumin ratio, Procalcitonin/albumin and neutrophil/lymphocyte ratio showed significant results p ≤ 0.05. When associating the severity of the TBI with the patient’s outcome, it was noted that the highest incidence of mortality occurred in the severe group, with 15 (41.7%) of the total group, compared to those who suffered a moderate TBI, where 3 (10.0%) died, resulting in a significant result of p = 0.008. ROC curve analyses were performed on the procalcitonin/albumin ratio, which showed a cutoff point of 0.67 (sensitivity of 83.3% and specificity of 35.3%), with a result of p = 0.037. Conclusion: in the independent analysis according to outcome, the procalcitonin, procalcitonin/albumin, and neutrophil/lymphocyte ratio indicators showed higher values in the deceased patients; Furthermore, the utility assessed through the area under the curve of procalcitonin, procalcitonin/albumin and neutrophil/lymphocyte were clinically relevant in the population.


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