C-Reactive Protein and D-dimer as Prognostic Markers for Clinical Outcomes in Patients with Mild Traumatic Brain Injury: A Cross-Sectional Study.

Abstract

Objective: To investigate the use of prognostic markers such as C-reactive protein (CRP) and D-dimer for clinical outcomes in patients with mild traumatic brain injury (TBI).

Methods: This cross-sectional study was conducted on patients with mild head trauma who were admitted to the Emergency Department of Imam Khomeini Hospital (Sari, Iran). Data were collected from 2018 to 2019. Age, sex, the time of injury hospitalization, length of hospitalization, length of unconsciousness, blood pressure, heart rate, respiratory rate, and concomitant symptoms were all recorded using a pre-designed checklist. The patient's Glasgow Coma Scale (GCS), CRP, and D-dimer were also measured. Moreover, all patients underwent CT scan.

Results: This study included 74 patients with TBI. The mean age of the participants was 36.92±3.54. The mean CRP and D-dimer values were 5.69±0.77 and 0.58±0.11 in these patients, respectively. At the cut-off point of 11.50 for CRP, the sensitivity and specificity to detect the pathological lesions in CT scan were 75% and 95.50%, respectively (p<0.001). Additionally, with a D-dimer cut-off point of 0.90, the sensitivity and specificity for diagnosing pathological lesions in CT scan were 100% and 98.50%, respectively (p<0.001).

Conclusion: In general, the CRP and D-dimer levels of patients with mild TBI (GCS≥13) can be assessed to protect against CT-induced radiation exposure and subsequent disorders; if they do not exhibit clinical signs to increase the risk of adverse brain damage, such as reduced level of consciousness, drowsiness, and prolonged periods of unconsciousness.