Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)

Background: Traumatic brain injury (TBI) is a major public health concern. Creatinine (Cr) has been well studied as a marker of renal function, specifically the development of acute kidney injury (AKI) in TBI patients. We aimed to evaluate the effect of Cr on various clinical outcomes in patients with severe TBI. Methods: We investigated the relationship between Cr levels at various time points and a range of clinical variables, using parametric (ANOVA, two-tailed t-test, and linear regression modeling) statistical testing. Results: 1,000 patients were included in our study. We found a significant association between sex and Cr level at intensive care unit (ICU) admission (p=0.001) and ICU discharge (p=0.005). Degree of creatinemia had a significant effect on both mean ISS (p=0.0003) and GCS (p=0.004) scores at ICU admission as well as ISS (p=0.017) and GCS (p=0.001) scores at patient death timepoints. Change in Cr from Hospital to ICU admission was significantly correlated with vent days (p=0.045). Change in Cr from ICU admission to ICU discharge was significantly correlated with hospital length of stay (LOS; p=0.001), ICU LOS (p=0.000), and vent days (p=0.011). Overall, there were significant correlations between Cr at admission and ICU LOS (p=0.043), Cr at ICU admission and ICU LOS (p=0.001), and Cr at ICU admission and vent days (p=0.031). Conclusion: Our findings support existing literature that demonstrates a positive relationship between Cr levels, ICU LOS, and vent days amongst patients with severe TBI.