Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)
Abstract
1. Introduction
2. Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Male | Female | p-Value | |
---|---|---|---|
N (%) | 768 (77%) | 232 (23%) | |
Age (mean ± SD) | 48.88 ± 19.87 years | 65.04 ± 23.90 years | 0.000 |
Patient Weight (mean ± SD) | 91.11 ± 42.09 kg | 74.12 ± 36.69 kg | 0.000 |
Creatinine at Various Timepoints | |||
Hospital Admission (mean ± SD) | 0.96 ± 0.80 mg/dL | 0.89 ± 0.73 mg/dL | 0.241 |
ICU Admission (mean ± SD) | 0.60 ± 0.79 mg/dL | 0.45 ± 0.49 mg/dL | 0.001 |
ICU Discharge (mean ± SD) | 0.58 ± 1.83 mg/dL | 0.37 ± 0.47 mg/dL | 0.005 |
Hospital Discharge (mean ± SD) | 0.74 ± 3.19 mg/dL | 0.82 ± 3.82 mg/dL | 0.770 |
Death (mean ± SD) | 1.48 ± 37.89 mg/dL | 0.06 ± 0.34 mg/dL | 0.303 |
Race (n, %) | 0.000 | ||
White | 128 (17%) | 53 (23%) | |
Black | 61 (8%) | 16 (7%) | |
Asian | 92 (12%) | 55 (23%) | |
Native Hawaiian or Other Pacific Islander | 2 (0.25%) | 2 (1%) | |
Other | 469 (61%) | 102 (44%) | |
Unknown | 14 (2%) | 4 (2%) | |
Ethnicity (n, %) | 0.000 | ||
Hispanic | 384 (50%) | 80 (34%) | |
Non-Hispanic | 352 (46%) | 142 (61%) | |
Unknown | 31 (4%) | 10 (5%) | |
Trauma Type (n, %) | 0.133 | ||
Blunt | 749 (98%) | 230 (99%) | |
Penetrating | 19 (2%) | 2 (1%) | |
Glasgow Coma Score (mean ± SD) | 9 ± 6 | 15 ± 0 | 0.000 |
Injury Severity Score (mean ± SD) | 19.5 ± 1.5 | 20 ± 2 | 0.498 |
Hospital Length of Stay (mean ± SD) | 12.32 ± 21.6 | 9.55 ± 13.72 | 0.066 |
ICU Length of Stay (mean ± SD) | 4.11 ± 7.63 | 2.66 ± 5.17 | 0.007 |
Ventilator Days (mean ± SD) | 2.13 ± 6.88 | 0.80 ± 2.81 | 0.004 |
Injury Pattern (n, %) | 0.103 | ||
EDH | 0 (0%) | 1 (0%) | |
SDH | 1 (0%) | 0 (0%) | |
SAH | 338 (28%) | 86 (26%) | |
IPH | 603 (50%) | 190 (57%) | |
Concussion | 11 (1%) | 4 (1%) | |
Other | 248 (21%) | 55 (16%) | |
Mortality (n, %) | 83 (11%) | 25 (11%) | 0.975 |
Hospital Admission Cr (mg/dL) | ICU Admission Cr (mg/dL) | ICU Discharge Cr (mg/dL) | Hospital Discharge Cr (mg/dL) | Death Cr (mg/dL) | ||
---|---|---|---|---|---|---|
Sex | Female | 0.894 | 0.454 | 0.373 | 0.821 | 0.063 |
Male | 0.963 | 0.603 | 0.577 | 0.740 | 1.475 | |
p-value | 0.241 | 0.001 | 0.005 | 0.770 | 0.303 | |
Age Range | Under 18 | 0.696 | 0.530 | 0.434 | 0.440 | 0.000 |
18–45 | 0.903 | 0.552 | 0.608 | 0.548 | 0.077 | |
46–74 | 0.973 | 0.593 | 0.494 | 0.800 | 2.866 | |
75+ | 0.974 | 0.563 | 0.455 | 1.08 | 0.151 | |
p-value | 0.283 | 0.947 | 0.806 | 0.443 | 0.804 | |
Injury Type | Blunt | 0.9455 | 0.569 | 0.532 | 0.760 | 1.168 |
Penetrating | 0.978 | 0.519 | 0.416 | 0.6901 | 0.138 | |
p-value | 0.754 | 0.657 | 0.309 | 0.617 | 0.339 | |
Injury Mechanism | Fall | 0.981 | 0.555 | 0.520 | 0.880 | 1.781 |
Blunt Assault | 0.909 | 0.634 | 0.578 | 0.636 | 0.071 | |
MVC | 0.886 | 0.554 | 0.600 | 0.464 | 0.171 | |
Pedestrian Struck | 0.871 | 0.616 | 0.530 | 0.532 | 0.158 | |
Micro MVC | 0.846 | 0.564 | 0.501 | 0.534 | 0.026 | |
Penetrating Assault | 0.996 | 0.545 | 0.437 | 0.696 | 0.145 | |
Other | 0.843 | 0.302 | 0.209 | 0.672 | 0.000 | |
p-value | 0.693 | 0.802 | 0.992 | 0.888 | 0.997 | |
Diagnosis | SDH | 1.550 | 0.000 | 0.000 | 0.000 | 0.000 |
SAH | 0.942 | 0.605 | 0.628 | 0.600 | 0.129 | |
EDH | 0.640 | 0.460 | 0.530 | 0.610 | 0.000 | |
IPH | 0.962 | 0.577 | 0.556 | 0.809 | 1.433 | |
Concussion | 1.160 | 0.786 | 0.707 | 0.489 | 0.293 | |
Other | 0.884 | 0.560 | 0.486 | 0.560 | 0.097 | |
p-value | >0.05 | >0.05 | >0.05 | >0.05 | >0.05 | |
Number of Injuries | One | 0.979 | 0.550 | 0.457 | 0.936 | 2.140 |
Two | 0.886 | 0.546 | 0.595 | 0.548 | 0.119 | |
Three | 1.040 | 0.734 | 0.700 | 0.689 | 0.165 | |
Four+ | 0.844 | 0.732 | 0.498 | 0.465 | 0.104 | |
p-value | 0.217 | 0.124 | 0.469 | 0.399 | 0.831 |
Extreme Hyper-Creatinemia (mg/dL) | Hyper-Creatinemia (mg/dL) | Normo-Creatinemia (mg/dL) | Hypo-Creatinemia (mg/dL) | Extreme Hypo-Creatinemia (mg/dL) | p-Value | ||
---|---|---|---|---|---|---|---|
Cr at Hospital Admission | N | 107 | 61 | 574 | 38 | 179 | |
ISS | 19.78 | 21.75 | 18.17 | 17.34 | 18.05 | 0.011 | |
GCS | 12.05 | 12.28 | 12.74 | 13.32 | 13.00 | 0.149 | |
Cr at ICU Admission | N | 58 | 31 | 321 | 21 | 191 | |
ISS | 20.81 | 22.16 | 19.89 | 18.90 | 17.29 | 0.000 | |
GCS | 11.79 | 12.61 | 12.16 | 13.48 | 13.10 | 0.001 | |
Cr at ICU Discharge | N | 43 | 11 | 236 | 32 | 259 | |
ISS | 19.95 | 17.64 | 19.21 | 18.44 | 18.20 | 0.069 | |
GCS | 11.84 | 14.64 | 12.75 | 12.53 | 12.74 | 0.578 | |
Cr at Hospital Discharge | N | 31 | 17 | 381 | 29 | 255 | |
ISS | 20.32 | 19.18 | 17.83 | 17.79 | 18.91 | 0.461 | |
GCS | 12.26 | 14.47 | 13.07 | 12.86 | 12.43 | 0.162 | |
Cr at Death | N | 11 | 2 | 13 | 81 | 11 | |
ISS | 21.00 | 26.25 | 19.10 | 38.50 | 18.36 | 0.003 | |
GCS | 10.33 | 11.75 | 11.14 | 6.50 | 12.84 | 0.039 |
Timeframe | Mean Cr ± SE (mg/dL) | Scoring System | Rho Coefficient | p-Value |
---|---|---|---|---|
Hospital Admission | 0.945 ± 0.025 | ISS | 0.106 | 0.000 |
GCS | −0.114 | 0.001 | ||
ICU Admission | 0.568 ± 0.023 | ISS | 0.179 | 0.000 |
GCS | −0.182 | 0.000 | ||
ICU Discharge | 0.529 ± 0.051 | ISS | 0.104 | 0.001 |
GCS | −0.103 | 0.001 | ||
Hospital Discharge | 0.759 ± 0.106 | ISS | −0.035 | 0.279 |
GCS | 0.005 | 0.868 | ||
Death | 1.147 ± 1.051 | ISS | 0.104 | 0.001 |
GCS | −0.097 | 0.002 |
Timeframe | Outcome | p-Value | Coefficient ± SE [95% CI] |
---|---|---|---|
Change in Cr Level from Hospital Admission to ICU Admission | Hospital LOS | 0.497 | −0.550 ± 0.808 [−2.14–1.04] |
ICU LOS | 0.265 | −0.321 ± 0.288 [−0.887–0.244] | |
Ventilator Days | 0.045 | −0.500 ± 0.249 [−0.989–−0.011] | |
Mortality | 0.139 | −0.019 ± 0.013 [−0.043–0.006] | |
Change in Cr Level from ICU Admission to ICU Discharge | Hospital LOS | 0.001 | −1.380 ± 0.408 [−2.180–−0.580] |
ICU LOS | 0.000 | −0.542 ± 0.145 [−0.827–−0.257] | |
Ventilator Days | 0.011 | −0.322 ± 0.126 [−0.569–−0.074] | |
Mortality | 0.148 | 0.009 ± 0.006 [−0.003–0.022] |
Timeframe | Outcome | p-Value | Coefficient ± SE [95% CI] |
---|---|---|---|
Change in Cr Level from Hospital Admission to ICU Admission | Ventilator Days | 0.090 | −0.444 ± 0.262 [−0.959–0.070] |
Change in Cr Level from ICU Admission to ICU Discharge | Hospital LOS | 0.001 | −1.394 ± 0.416 [−2.211–−0.577] |
ICU LOS | 0.000 | −0.543 ± 0.147 [−0.832–−0.255] | |
Ventilator Days | 0.014 | −0.320 ± 0.130 [−0.575–−0.065] |
Number of Injuries | Timeframe | Outcome | p-Value | Coefficient ± SE 95% CI |
---|---|---|---|---|
Overall | Cr at Admission | Hospital LOS | 0.472 | 0.584 ± 0.811 [−1.008–2.175] |
ICU LOS | 0.043 | 0.586 ± 0.288 [0.019–1.152] | ||
Ventilator Days | 0.981 | 0.006 ± 0.250 [−0.486–0.497] | ||
Mortality | 0.755 | −0.004 ± 0.013 [−0.029–0.021] | ||
Cr at ICU Admission | Hospital LOS | 0.135 | 1.289 ± 0.863 [−0.404–2.982] | |
ICU LOS | 0.001 | 1.029 ± 0.306 [0.429–1.630] | ||
Ventilator Days | 0.031 | 0.576 ± 0.266 [0.054–1.098] | ||
Mortality | 0.211 | 0.017 ± 0.013 [−0.010–0.043] | ||
Cr at ICU Discharge | Mortality | 0.417 | −0.005 ± 0.001 [−0.017–0.007] | |
1 Injury | Cr at Admission | Hospital LOS | 0.174 | 0.617 ± 0.453 [−0.272–1.506] |
ICU LOS | 0.061 | 0.404 ± 0.215 [−0.019–0.826] | ||
Ventilator Days | 0.408 | 0.113 ± 0.136 [−0.155–0.391] | ||
Mortality | 0.948 | 0.001 ± 0.011 [−0.022–0.023] | ||
Cr at ICU Admission | Hospital LOS | 0.024 | 1.238 ± 0.162 [0.162–2.315] | |
ICU LOS | 0.003 | 0.766 ± 0.255 [0.255–1.276] | ||
Ventilator Days | 0.002 | 0.508 ± 0.164 [0.186–0.831] | ||
Mortality | 0.197 | 0.018 ± 0.014 [−0.009–0.045] | ||
Cr at ICU Discharge | Mortality | 0.274 | −0.017 ± 0.016 [−0.049–0.014] | |
2 Injuries | Cr at Admission | Hospital LOS | 0.927 | 0.314 ± 3.433 [−6.437–7.065] |
ICU LOS | 0.029 | 2.629 ± 1.196 [0.277–4.980] | ||
Ventilator Days | 0.516 | 0.562 ± 0.865 [−1.139–2.263] | ||
Mortality | 0.613 | 0.024 ± 0.048 [−0.070–0.119] | ||
Cr at ICU Admission | Hospital LOS | 0.420 | 2.151 ± 2.662 [−3.083–7.385] | |
ICU LOS | 0.010 | 2.399 ± 0.929 [0.572–4.227] | ||
Ventilator Days | 0.154 | 0.960 ± 0.672 [−0.362–2.285] | ||
Mortality | 0.602 | 0.019 ± 0.037 [−0.053–0.093] | ||
Cr at ICU Discharge | Mortality | 0.577 | −0.004 ± 0.008 [−0.019–0.011] | |
3 Injuries | Cr at Admission | Hospital LOS | 0.824 | 0.802 ± 3.591 [−6.337–7.942] |
ICU LOS | 0.699 | 0.365 ± 0. 940 [−1.504–2.234] | ||
Ventilator Days | 0.478 | −1.111 ± 1.559 [−4.209–1.988] | ||
Mortality | 0.420 | −0.028 ± 0.035 [−0.098–0.041] | ||
Cr at ICU Admission | Hospital LOS | 0.747 | −0.938 ± 2.894 [−6.691–4.816] | |
ICU LOS | 0.936 | 0.061 ± 0.757 [−1.443–1.566] | ||
Ventilator Days | 0.956 | −0.070 ± 1.257 [−2.569–2.429] | ||
Mortality | 0.958 | −0.001 ± 0.028 [−0.058–0.055] | ||
Cr at ICU Discharge | Mortality | 0.943 | −0.002 ± 0.028 [−0.058–0.054] | |
4+ Injuries | Cr at Admission | Hospital LOS | 0.469 | 10.642 ± 14.241 [−20.387–41.671] |
ICU LOS | 0.159 | 7.644 ± 5.085 [−3.435–18.723] | ||
Ventilator Days | 0.406 | 3.980 ± 4.622 [−6.090–14.050] | ||
Mortality | 0.203 | −0.478 ± 0.355 [−1.251–0.296] | ||
Cr at ICU Admission | Hospital LOS | 0.549 | −7.523 ± 12.209 [−34.124–19.078] | |
ICU LOS | 0.863 | 0.832 ± 4.712 [−9.435–11.098] | ||
Ventilator Days | 0.924 | 0.397 ± 4.052 [−8.432–9.225] | ||
Mortality | 0.198 | 0.411 ± 0.302 [−0.246–1.068] | ||
Cr at ICU Discharge | Mortality | 0.133 | −0.547 ± 0.339 [−1.285–0.192] |
Timeframe | Outcome | p-Value | Coefficient ± SE [95% CI] | |
---|---|---|---|---|
Overall | Cr at Admission | ICU LOS | 0.038 | 0.621 ± 0.298 [0.036–1.206] |
Cr at ICU Admission | ICU LOS | 0.002 | 1.010 ± 0.321 [0.379–1.640] | |
Ventilator Days | 0.062 | 0.529 ± 0.283 [−0.027–1.085] | ||
1 Injury | Cr at ICU Admission | Hospital LOS | 0.031 | 1.242 ± 0.575 [0.111–2.372] |
ICU LOS | 0.003 | 0.817 ± 0.276 [0.273–1.360] | ||
Ventilator Days | 0.003 | 0.538 ± 0.179 [0.186–0.889] | ||
2 Injuries | Cr at Admission | ICU LOS | 0.034 | 2.689 ± 1.262 [0.206–5.172] |
Cr at ICU Admission | ICU LOS | 0.017 | 2.333 ± 0.973 [0.420–4.246] |
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Dawson-Moroz, S.; Rancy, S.; Agriantonis, G.; Twelker, K.; Bhatia, N.D.; Shafaee, Z.; Whittington, J.; Sharma, B. Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI). Metabolites 2025, 15, 657. https://doi.org/10.3390/metabo15100657
Dawson-Moroz S, Rancy S, Agriantonis G, Twelker K, Bhatia ND, Shafaee Z, Whittington J, Sharma B. Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI). Metabolites. 2025; 15(10):657. https://doi.org/10.3390/metabo15100657
Chicago/Turabian StyleDawson-Moroz, Sarah, Schneider Rancy, George Agriantonis, Kate Twelker, Navin D. Bhatia, Zahra Shafaee, Jennifer Whittington, and Bharti Sharma. 2025. "Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI)" Metabolites 15, no. 10: 657. https://doi.org/10.3390/metabo15100657
APA StyleDawson-Moroz, S., Rancy, S., Agriantonis, G., Twelker, K., Bhatia, N. D., Shafaee, Z., Whittington, J., & Sharma, B. (2025). Effect of Creatinine on Various Clinical Outcomes in Patients with Severe Traumatic Brain Injury (TBI). Metabolites, 15(10), 657. https://doi.org/10.3390/metabo15100657