Objective This study aimed to assess the utility of hsCRP as a blood-based biomarker for the prognosis of mTBI.

Design Retrospective cohort study.

Setting Outpatient neurology clinic in New York City.

Participants Serum hsCRP values were retrospectively collected from 311 patients diagnosed with mTBI (Glasgow Coma Scale ≤ 13). Average age at injury: 21.1 ± 12.4. 53% Female, 86% White.

Interventions (or Assessment of Risk Factors) hsCRP blood samples drawn as prognostic measurement post-injury. The level was measured on first clinical assessment and periodically reassessed until recovery.

Outcome Measures hsCRP levels were measured for patients and repeated at subsequent visits for values ≥1.0 mg/L until values were <1.0 mg/L. For data analysis, hsCRP levels were transformed into quartiles, <0.200mg/L (Q1); 0.200–0.415mg/L (Q2); 0.415–1.100mg/L (Q3); and >1.100mg/L (Q4). Data were analyzed using non-parametric Mann-Whitney U and Kruskal Wallis tests. Multivariable logistic regression modeling was performed to identify potential factors associated with elevated hsCRP levels in Q4.

Main Results hsCRP levels were elevated in cohort of individuals presenting within 1 week of injury and decreased significantly between the first visit and 4 weeks post-injury (p=0.016). Initial hsCRP level was associated with age, with mean age increasing significantly between quartiles (p=0.013). Patients with increased age (OR: 1.03, 95% CI: 1.01, 1.05) and those who endorsed headache (OR: 3.48) or fatigue (OR: 2.16) were significantly associated with increased risk of having an hsCRP level in Q4.

Conclusions hsCRP may be a useful addition to acute and longitudinal biomarker panels for prognosis of mTBI.