Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Prognostic value of procalcitonin and IL-6 with a composite model in moderate-severe traumatic brain injury.
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Li Xin-Meng, Liu Zi-Wei, Liu Wei-Yu, Su Gao-Jian, Huang Xian-Jian
Аннотация
BACKGROUND: Inflammation is a critical secondary injury mechanism in craniocerebral trauma, which contributes to further tissue damage and long-term neurological deficits. This inflammatory response is primarily a neurotoxic injury mediated through the production of inflammatory factors by the inflammatory cells. Among these, IL-6 is the most promising biomarker for the clinical diagnosis of brain injury, and procalcitonin (PCT) is a promising biomarker specific for bacterial infection. This study aimed to investigate the relationship between IL and 6 and PCT concentrations at admission and the Glasgow Outcome Score (GOS) at 6 months post-discharge in patients with moderate-to-severe traumatic brain injury (TBI).
METHODS: This retrospective study included 122 patients with moderate-to-severe TBI (Glasgow Coma Scale [GCS] 3-12) admitted to Shenzhen Second People's Hospital between January 2019 and June 2024. GOS scores at 6 months after discharge were recorded. Outcomes were dichotomized into favorable and unfavorable. Associations between IL and 6, PCT, and clinical characteristics were assessed via chi-square tests. Multivariate logistic regression identified independent prognostic factors for GOS, whereas ROC analysis evaluated the predictive performance (AUC) of biomarkers and composite models.
RESULTS: In total, 50 and 72 patients were categorized into the poor and good prognosis groups, respectively. Among these, 14 cases resulted in fatality. Initial serum analysis demonstrated significantly higher PCT (p < 0.001) and IL-6 (p = 0.001), but lower hemoglobin (p = 0.003) in the poor-prognosis group. Multivariate analysis identified six independent predictors of 6-month GOS outcomes: hemoglobin (OR = 1.03, p = 0.002), albumin (OR = 1.06, p = 0.035), IL-6 (OR = 1.00, p = 0.003), PCT (OR = 0.74, p = 0.015), GCS (OR = 1.49, p < 0.001), and creatinine (OR = 0.97, p = 0.001). Prognostic performance analysis demonstrated that the individual biomarkers IL-6 and PCT achieved AUC of 0.716 and 0.709, respectively. Notably, the composite model incorporating all six predictors exhibited a superior discriminative ability (AUC = 0.917).
CONCLUSION: PCT and IL-6 levels are associated with the outcomes of patients with moderate-to-severe TBI and may serve as effective prognostic indicators.
METHODS: This retrospective study included 122 patients with moderate-to-severe TBI (Glasgow Coma Scale [GCS] 3-12) admitted to Shenzhen Second People's Hospital between January 2019 and June 2024. GOS scores at 6 months after discharge were recorded. Outcomes were dichotomized into favorable and unfavorable. Associations between IL and 6, PCT, and clinical characteristics were assessed via chi-square tests. Multivariate logistic regression identified independent prognostic factors for GOS, whereas ROC analysis evaluated the predictive performance (AUC) of biomarkers and composite models.
RESULTS: In total, 50 and 72 patients were categorized into the poor and good prognosis groups, respectively. Among these, 14 cases resulted in fatality. Initial serum analysis demonstrated significantly higher PCT (p < 0.001) and IL-6 (p = 0.001), but lower hemoglobin (p = 0.003) in the poor-prognosis group. Multivariate analysis identified six independent predictors of 6-month GOS outcomes: hemoglobin (OR = 1.03, p = 0.002), albumin (OR = 1.06, p = 0.035), IL-6 (OR = 1.00, p = 0.003), PCT (OR = 0.74, p = 0.015), GCS (OR = 1.49, p < 0.001), and creatinine (OR = 0.97, p = 0.001). Prognostic performance analysis demonstrated that the individual biomarkers IL-6 and PCT achieved AUC of 0.716 and 0.709, respectively. Notably, the composite model incorporating all six predictors exhibited a superior discriminative ability (AUC = 0.917).
CONCLUSION: PCT and IL-6 levels are associated with the outcomes of patients with moderate-to-severe TBI and may serve as effective prognostic indicators.