Prognostic value of admission serum albumin levels in patients with head injury

ABSTRACT

Head injury is major cause of disability and death in the society, however no effective biochemical prognostic markers are available. To assess the prognostic significance of admission serum albumin levels in patients of head injury. Prospective cohort study with control group. Within 24 hours of head injury, 154 patients underwent serum analysis for albumin along with 38 normal volunteers, studied in relation to various factors and subsequently followed-up. Statistical analysis was made with SPSS software, p<0.05 was considered significant. Mean serum albumin in head injury and control were 3.24 and 4.15 g/dL respectively [p<0.001]. Admission albumin had significant positive correlation with Glasgow coma score [GCS] [p<0.001]. Hypoalbuminemia [patients with severe, moderate and mild head injury respectively [p<0.001]. Significantly lower albumin levels were observed in patients with associated systemic injury; those requiring surgical decompression and in the elderly. Mortality at 1 month was 43% in patients with admission hypoalbuminemia as compared to 17% in those with normal albumin levels [odds ratio [OR] 3.7, p=0.003-. Unfavourable outcome at 3 months was noted in 62% of patients with admission hypoalbuminemia as compared to 18% of those having normal albumin levels [OR 7.3, p<0.001]. In multiple logistic regression analysis, admission hypoalbuminemia emerged as an independent predictor for unfavourable outcome, in addition to age and GCS. Admission hypoalbuminemia is an effective indicator of the severity of head injury, and an independent predictor for unfavourable outcome at 3 months