Kadir ARSLAN, Deniz Yasemin KELEŞ DURAN, Ayca Sultan SAHIN
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(2):402-408
Aim: Traumatic brain injury (TBI) is a serious clinical condition associated with high mortality and neurological sequelae. This study aims to evaluate the prognostic role of the Glasgow Coma Scale -Pupils score (GCS -P) and the C -reactive protein -to-albumin ratio (CAR) on mortality in patients with moderate and severe TBI. Methods: In this retrospective observational study, patients with moderate -to-severe TBI admitted to and treated in the ICU between January 2021 and June 2023 were included. Patients were classified into survivors and non -survivors. Demographic and clinical characteristics, GCS, GCS -P, and CAR were recorded. CAR was calculated by dividing the CRP level by the albumin level obtained from routine blood tests at admission. Results: The study cohort comprised 177 patients, with an in -hospital mortality rate of 22%. In non -survivors, GCS and GCS -P scores were significantly lower and CAR was significantly higher (all p < 0.001). In multivariable analysis, GCS -P (OR = 0.425, p = 0.028) and CAR (OR = 1.275, p = 0.022) were independent predictors of mortality. The cut -off for GCS -P was <=4.5 (AUC = 0.863) and for CAR >=0.07 (AUC = 0.721). Conclusion: In patients with moderate -to-severe TBI admitted to the ICU, GCS -P score and CAR are independent predictors of in -hospital mortality. The combined use of GCS -P, reflecting neurological status, and CAR, reflecting systemic inflammation and nutritional status, may provide additional prognostic value.
