医学
逻辑回归
创伤性脑损伤
白蛋白
格拉斯哥昏迷指数
内科学
格拉斯哥结局量表
结果(博弈论)
血清白蛋白
外科
精神科
数学
数理经济学
作者
Françis Bernard,Yahia Al-Tamimi,Doris A. Chatfield,Andy G. Lynch,Basil F. Matta,David Menon
出处
期刊:Journal of Trauma-injury Infection and Critical Care
[Lippincott Williams & Wilkins]
日期:2008-04-01
卷期号:64 (4): 872-875
被引量:44
标识
DOI:10.1097/ta.0b013e31803428cc
摘要
Serum albumin level is correlated with outcome in various clinical situations. Albumin has multiple physiologic properties that could be beneficial in brain injury. The Lund therapy for elevated intracranial pressure uses albumin as part of its protocol and demonstrates favorable outcome. We sought to find out if albumin is associated with outcome after traumatic brain injury to justify conducting a randomized trial.A retrospective study of traumatic brain injury patients was conducted. Characteristics known to influence outcome were included in a multiple logistic regression model to analyze predictors of poor outcome at 6 months.Data were available for 138 patients. The majority of patients (65%) had a severe injury (Glasgow Coma Scale score <9). Seventy percent of patients had a favorable outcome. Albumin levels decrease considerably from normal values in the first few days after injury irrespective of outcome. Albumin remained <25 g/L for a longer period of time in patient with an unfavorable outcome (6 days vs. 3 days, p = 0.012). Multiple logistic regression analysis identified albumin levels, age, Glasgow Coma Scale score at admission, and Injury Severity Score as predictors of poor outcome.Serum albumin level seems to be an independent predictor of poor outcome. The model also identified classic predictors of poor outcome that tends to strengthen its adequacy. Because albumin level is the only modifiable factor influencing outcome, it seems justified to carry out a randomized trial of the use of albumin in the treatment of brain injury.
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