The CSF-serum albumin quotient as a biomarker of severe traumatic brain injury: A pilot study
Background: Severe traumatic brain injury (TBI) can disrupt blood–brain barrier permeability and increase transfer of albumin from the serum to the cerebrospinal fluid (CSF). A high CSF/serum albumin quotient (QAlb) is a biomarker for blood brain barrier (BBB) permeability and may be a measure of th...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
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| Series: | World Neurosurgery: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139725000201 |
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| Summary: | Background: Severe traumatic brain injury (TBI) can disrupt blood–brain barrier permeability and increase transfer of albumin from the serum to the cerebrospinal fluid (CSF). A high CSF/serum albumin quotient (QAlb) is a biomarker for blood brain barrier (BBB) permeability and may be a measure of the severity of TBI. The aim of this study was to determine if the QAlb was abnormal in patients with severe TBI and whether an abnormal QAlb was associated with long-term outcomes. Methods: For this prospective cohort study, the eligible TBI population had extra-ventricular drains inserted. Uninjured patients underwent lumbar puncture for non-trauma indications, with patients who had abnormal CSF samples excluded. The primary outcome was the Glasgow Outcome Scale- Extended (GOSE) at 6 months. Results: There were 24 patients with TBI and 5 control subjects included. Among patients with TBI, the median initial GCS was 3.5 (IQR 3–6.5). A high QAlb was observed in 10 (41.7 %) patients with TBI and no uninjured patient had high QAlb. Among TBI patients with high QAlb, the median 6-month GOSE was 3 (IQR 2–4) compared to median GOSE of 6.5 (IQR 3–7) among patients with normal QAlb (p = 0.06). The association between high QAlb and unfavourable GOSE at 6 months (OR 5.3; 95 %CI: 0.82–34.8; p = 0.08) did not reach statistical significance. Conclusions: A high QAlb was observed among a subgroup of patients with severe TBI and may be associated with worse long-term outcomes. Further evaluation of this biomarker as a prognostic tool after severe TBI is indicated. |
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| ISSN: | 2590-1397 |