Evaluation of serum albumin as a prognostic marker in traumatic brain injury

Introduction: Traumatic Brain Injury (TBI) due to road traffic accidents is one of the leading causes of mortality and morbidity in India. Since albumin is associated with the patho-physiological events following TBI, we aimed to estimate the same in these patients and to find whether it can be used as biomarker. Materials and Method: Fifty four consecutive patients admitted to our emergency intensive care with varying degrees of head injuries, were grouped into 3 categories based on the admission time Glasgow Coma Scale (GCS) as mild (13 to 15), moderate (9-12), and severe brain injury(8 or less) and their serum albumin were estimated. Results: Out of 54 patients, 15 had hypoalbuminemia (albumin <3.5g/dL), while for the rest the levels were normal. In the normal albumin group 87% patients showed good outcome and only 13% showed poor outcome. With Kaplan-Meier survival curves, patients with normal albumin levels showed a significantly higher chance to survive than patients with hypoalbuminemia. Further stratification of our cohort into groups according to the interquartile range of serum albumin and comparing it with their clinical outcome by Cox regression indicated that the probability of mortality increased with the decrease in serum albumin (hazard ratio[HR] = 0.15; 95% CI = 0.03- 0.6) with a significant p value of <0.05. Conclusion: Serum albumin can be used as a prognostic markers in predicting the adverse outcome in TBI patients