Citation

Shetty T, Cogsil T, Dalal A, Kim E, Halvorsen K, Cummings K, Nguyen JT. J. Head Trauma Rehabil. 2019; 34(3): E28-E36.

Affiliation

Department of Neurology (Dr Shetty and Ms Cogsil, Kim, and Halvorsen) and Biostatistics Core (Mr Nguyen), Hospital for Special Surgery, New York, New York; New York Medical College, Valhalla (Ms Dalal); and SUNY Downstate Medical School, Brooklyn, New York (Ms Cummings).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000450

PMID

30499931

Abstract

OBJECTIVE: A panel of biomarkers is needed to definitively diagnose mild traumatic brain injury (mTBI). There is a clear role for the inclusion of an inflammatory biomarker. This study looked to find a relationship between high sensitivity C-reactive protein (hsCRP), an inflammatory biomarker, and mTBI. SETTING: Neurology department of high-volume tertiary orthopedic hospital. PARTICIPANTS: Individuals diagnosed with mTBI (n = 311, age 21 ± 12 years, 53% female).

DESIGN: Retrospective cohort study. MAIN MEASURES: hsCRP levels; postconcussive symptoms; demographics.

RESULTS: Continuous hsCRP levels were transformed into quartiles, as defined by less than 0.200 mg/L for quartile 1 (Q1); 0.200 to 0.415 mg/L for quartile 2 (Q2); 0.415 to 1.100 mg/L for quartile 3 (Q3); and greater than 1.100 mg/L for quartile 4 (Q4). Mean hsCRP was elevated in the cohort of individuals who presented within 1 week of injury and was found to significantly decrease between the first visit and 4 weeks postinjury (P =.016). Initial hsCRP level was positively correlated with age (r = 0.163, P =.004), and age significantly increased between quartiles (P =.013). Patients with increased age (odds ratio: 3.48) and those who endorsed headache (odds ratio: 3.48) or fatigue (odds ratio: 2.16) were significantly associated with increased risk of having an hsCRP level in Q4.

CONCLUSION: hsCRP may be a viable addition to acute and longitudinal biomarker panels for diagnosis and prognosis of mTBI.

Language: en