Chronic kidney disease as a predictive factor for poor prognosis in traumatic brain injury among older adults: a case-control study

Haoyang Mo; Fan Fan; Jian Liu; Wenfan Zhang; Qing Wang; Xiangning Yuan

doi:10.3389/fneur.2023.1286592

Chronic kidney disease as a predictive factor for poor prognosis in traumatic brain injury among older adults: a case-control study

Front Neurol. 2023 Nov 30:14:1286592. doi: 10.3389/fneur.2023.1286592. eCollection 2023.

Authors

Haoyang Mo^#^{1

2}, Fan Fan^#^{1

2}, Jian Liu^{1

2}, Wenfan Zhang³, Qing Wang⁴, Xiangning Yuan⁵

Affiliations

¹ Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
³ Department of Medical Record, Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁴ Department of Interventional Medicine and Vascular Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China.
⁵ Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

^# Contributed equally.

Abstract

Objective: Traumatic brain injury (TBI) is a highly prevalent neurological disorder that affects a gradually increasing proportion of older adults. Chronic kidney disease (CKD) significantly contributes to global years of life lost, with an estimated one-tenth of the global population affected by CKD. However, it remains unclear whether CKD impacts TBI prognosis. We conducted a case-control study to investigate the clinical outcomes of TBI patients with or without CKD comorbidity and identified the risk factors associated with a poor prognosis.

Methods: From January 2017 through April 2023, 11 patients with TBI and CKD were included, and 27 control TBI cases with normal kidney function were matched by age, gender, and admission Glasgow Coma Scale (GCS) score as the control group.

Results: The CKD TBI group had a significantly lower GCS score upon discharge (7.1 ± 5.9) compared to the non-CKD TBI group (13.1 ± 2.6) (p < 0.01). ICU stay time and hospitalization expenses were higher in the CKD group than the non-CKD group, though there were no statistical differences. Additionally, patients in the CKD TBI group had a higher frequency of hospital-acquired infections (54.4%) compared with those in the non-CKD TBI group (7.4%) (p < 0.01). The two groups exhibited no differences in hemoglobin levels, albumin levels, or coagulation function. Logistic regression analysis showed that advanced age, low admission GCS score, elevated blood urea, and creatinine levels were associated with a poor neurological prognosis.

Conclusion: TBI patients comorbid with CKD have a poorer prognosis than those with normal kidney function.

Keywords: chronic kidney disease; clinical research; glasgow coma scale score; prognosis; serum creatine; traumatic brain injury.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by National Natural Science Foundation of China (81900679) and Health and Family Planning Commission of Hunan Province (B20180889).