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 and non-parametric statistical testing. Results: 1000 patients were included in our study. We found a significant association between sex and Cr level at intensive care unit (ICU) admission and ICU discharge. Cr was positively correlated with ISS at hospital admission, ICU admission, ICU discharge, and at death. Conversely, Cr was negatively correlated with GCS at hospital admission, ICU admission, ICU discharge, and at death. Larger decreases in Cr from Hospital to ICU admission were significantly correlated with increased vent days. Larger decreases in Cr from ICU admission to ICU discharge were significantly correlated with increased hospital length of stay (LOS), ICU LOS, and vent days, likely reflecting the degree of initial hypercreatinemia. For all patients, there were significant positive correlations between Cr at admission and ICU LOS, Cr at ICU admission and ICU LOS, and Cr at ICU admission and vent days. Conclusions: Our findings support existing literature that demonstrates a positive relationship between Cr levels, ICU LOS, and vent days amongst patients with severe TBI. These data suggest renal injury is predictive of TBI outcomes. Future research should investigate the role of renal therapeutic interventions in TBI recovery.