Evalution of Lactate to Albumin and C-reactive Protein to Albumin Ratios as Prognostic Biomarkers in Pediatric traumatic Brain injury: A Retrospective Observational Study

Pediatrictraumatic brain injury (TBI) is a leading cause of morbidity and mortality,necessitating accurate prognostic tools for early risk stratification.Traditional tools like the Glasgow Coma Scale (GCS) and Pediatric Index ofMortality 2 (PIM2) often fail to capture the complex metabolic and inflammatoryresponses associated with TBI. Emerging biomarkers, such as thelactate-to-albumin ratio (LAR) and C-reactive protein-to-albumin ratio (CAR),offer a more nuanced evaluation of systemic inflammation, hypoperfusion, andnutritional status. This study evaluates the utility of LAR and CAR asprognostic markers for mortality in pediatric TBI, comparing their predictiveaccuracy with GCS and PIM2. The findings aim to establish these markers ascost-effective, accessible tools to enhance clinical decision-making and improveoutcomes, especially in resource-limited settings.By analyzing 18 months of data (July 2023–January 2025) from an ongoing ICMR project at AIIMS, New Delhi, the study compares LAR and CAR with existing prognostic markers. Key outcomes include mortality at 24 hours, 30 days, and 90 days, along with ICU stay, mechanical ventilation, and inotrope support, aiming to establish these biomarkers as cost-effective tools for clinical decision-making.