Correlation Between C-Reactive Protein Levels and GOSE Score in Patients with Mild to Moderate Traumatic Brain Injury

Abstract

Background: Traumatic brain injury (TBI) is a significant public health concern. Mild to moderate TBI often receives less attention, even though it can result in substantial functional impairment. Inflammatory biomarkers, such as C-reactive protein (CRP), are believed to serve as predictors of neurological outcomes and may assist in clinical management. Objective: This study aimed to assess the correlation between CRP levels on the 3rd and 7th days post-injury and the Glasgow Outcome Scale–Extended (GOSE) score in patients with mild to moderate TBI. Methods: A prospective cohort study was conducted at Prof. Dr. R. D. Kandou Hospital, Manado, from January to March 2026, involving 36 hospitalized patients with mild to moderate TBI. Blood samples were collected on the 3rd and 7th days post-injury to measure CRP levels, while functional outcomes were assessed using the Glasgow Outcome Scale–Extended (GOSE) at one month post-injury. Data were analyzed using Spearman's correlation test and multivariate logistic regression. Results: The median CRP levels in patients with moderate TBI were higher than those in patients with mild TBI on day 3 (15.2 vs. 6.0 mg/L) and day 7 (20.9 vs. 7.7 mg/L). There was a strong negative correlation between CRP levels and GOSE scores (r = −0.647 for day 3 and r = −0.719 for day 7; p < 0.001), whereas changes in CRP levels (ΔCRP) showed no significant association with GOSE scores. Clinical factors, including the initial Glasgow Coma Scale (GCS) score and computed tomography (CT) findings, were also associated with functional outcomes. Conclusions: Elevated CRP levels, particularly on day 7 post-injury, were associated with poorer functional outcomes in patients with mild to moderate TBI, suggesting that CRP may serve as an early prognostic biomarker.