Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury

Abstract This study evaluated the clinical utility of C-reactive protein (CRP) and homocysteine (Hcy) as biomarkers for injury severity assessment and prognostic prediction in traumatic brain injury (TBI). A retrospective cohort study included 103 TBI patients (February 2020 to February 2023) strati...

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Main Authors: Zi-Yan Wang, Wei Du, Xian-Zhi Liu, Yuan Li, Jun Liu
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-02994-w
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author Zi-Yan Wang
Wei Du
Xian-Zhi Liu
Yuan Li
Jun Liu
author_facet Zi-Yan Wang
Wei Du
Xian-Zhi Liu
Yuan Li
Jun Liu
author_sort Zi-Yan Wang
collection DOAJ
description Abstract This study evaluated the clinical utility of C-reactive protein (CRP) and homocysteine (Hcy) as biomarkers for injury severity assessment and prognostic prediction in traumatic brain injury (TBI). A retrospective cohort study included 103 TBI patients (February 2020 to February 2023) stratified by Glasgow Coma Scale (GCS) scores into mild (n = 20), moderate (n = 32), and severe (n = 51) injury groups, alongside 20 healthy controls. Serum and cerebrospinal fluid (CSF) CRP and Hcy levels were measured serially over 14 days post-injury. Prognostic outcomes were assessed using 3-month Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) scores. Severe TBI patients exhibited significantly higher serum and CSF CRP levels than moderate/mild groups (p < 0.01), peaking within 72 h and remaining elevated through day 14. Serum Hcy levels increased rapidly post-injury, with severe cases sustaining prolonged elevations (> 7 days vs. ≤3 days in mild/moderate groups). CRP and Hcy levels inversely correlated with admission GCS scores (r = − 0.756, 0.756 and − 0.652, respectively; p < 0.001) and positively correlated with intracranial pressure (r = 0.829, 0.779 and 0.633). The initial CRP and Hcy levels were negatively correlated with GOS and positively correlated with mRS at 3 months post-injury, indicating their potential as biomarkers for assessing injury severity and predicting prognosis in TBI patients. CRP (serum/CSF) and serum Hcy are reliable biomarkers for assessing injury severity and predicting prognosis in TBI patients.
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spelling doaj-art-65fd5ac43d424c5a8c981a5bfc8a620c2025-08-20T03:16:32ZengNature PortfolioScientific Reports2045-23222025-05-011511910.1038/s41598-025-02994-wElevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injuryZi-Yan Wang0Wei Du1Xian-Zhi Liu2Yuan Li3Jun Liu4Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityAbstract This study evaluated the clinical utility of C-reactive protein (CRP) and homocysteine (Hcy) as biomarkers for injury severity assessment and prognostic prediction in traumatic brain injury (TBI). A retrospective cohort study included 103 TBI patients (February 2020 to February 2023) stratified by Glasgow Coma Scale (GCS) scores into mild (n = 20), moderate (n = 32), and severe (n = 51) injury groups, alongside 20 healthy controls. Serum and cerebrospinal fluid (CSF) CRP and Hcy levels were measured serially over 14 days post-injury. Prognostic outcomes were assessed using 3-month Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) scores. Severe TBI patients exhibited significantly higher serum and CSF CRP levels than moderate/mild groups (p < 0.01), peaking within 72 h and remaining elevated through day 14. Serum Hcy levels increased rapidly post-injury, with severe cases sustaining prolonged elevations (> 7 days vs. ≤3 days in mild/moderate groups). CRP and Hcy levels inversely correlated with admission GCS scores (r = − 0.756, 0.756 and − 0.652, respectively; p < 0.001) and positively correlated with intracranial pressure (r = 0.829, 0.779 and 0.633). The initial CRP and Hcy levels were negatively correlated with GOS and positively correlated with mRS at 3 months post-injury, indicating their potential as biomarkers for assessing injury severity and predicting prognosis in TBI patients. CRP (serum/CSF) and serum Hcy are reliable biomarkers for assessing injury severity and predicting prognosis in TBI patients.https://doi.org/10.1038/s41598-025-02994-wC reactive proteinHomocysteineTraumatic brain injury
spellingShingle Zi-Yan Wang
Wei Du
Xian-Zhi Liu
Yuan Li
Jun Liu
Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
Scientific Reports
C reactive protein
Homocysteine
Traumatic brain injury
title Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
title_full Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
title_fullStr Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
title_full_unstemmed Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
title_short Elevation of C-reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
title_sort elevation of c reactive protein and homocysteine levels as reliable biomarkers for assessing injury severity and prognosis in traumatic brain injury
topic C reactive protein
Homocysteine
Traumatic brain injury
url https://doi.org/10.1038/s41598-025-02994-w
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