Abstract text (incl. references and figure legends)
Introduction
The CRP albumin ratio (CAR), a novel inflammation-based prognostic score, is useful in predicting clinical outcomes, including those in central nervous system diseases. However, no report has identified the relationship between CAR and long-term clinical outcomes in patients with mild TBI (mTBI). We aimed to evaluate the relationship between CAR and long-term functional outcomes in patients with mTBI and analyze whether CAR is associated with the presence of fever.
Methods
This was a retrospective observational study on adult patients with mTBI who were transported to a level-1 trauma center between 2017 and 2021. The main exposure variable was an elevated CAR, and the main outcomes were degrees of disability and quality of life measured using the modified Rankin scale (mRs). A multivariable logistic regression analysis was performed to estimate the effect size of CAR on study outcomes. An interaction analysis was performed between CAR and fever on study outcomes.
Results
Elevated CAR had no significant association with poor functional outcomes (aOR [95% CI]: 1.35 [0.39–4.69]). In the interaction analysis, elevated CAR was not associated with increased poor functional outcomes in the absence of fever (1.08 [0.55–2.13]), but a significant increase in poor functional outcomes was observed when elevated CAR was accompanied by fever (1.32 (1.14-2.56)).
Conclusions
Elevated CAR with fever increased the risk of poor functional recovery at 6 months after hospital discharge in patients with mTBI. Our study findings form the basis of suggesting the need for strategies for the prevention of long-term poor functional recovery in the presence of CAR elevation and fever in patients with mTBI.
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