Objective:

We aim to assess the prognostic value of procalcitonin (PCT) in traumatic brain injury (TBI) patients.

Background:

Predicting TBI patients’ clinical outcomes is challenging. PCT have gained attention for its prognostic potential in other conditions; however, its role in TBI is still unclear.

Design/Methods:

We searched PubMed, Embase, Cochrane, Scopus, and Web of Science databases for studies measuring serum PCT levels post-TBI and addressing outcomes like sepsis, mortality, and infection. Quality assessment was conducted using the Newcastle-Ottawa Scale (NOS). We pooled PCT values as mean difference (MD) and 95% confidence intervals (CI). Heterogeneity was assessed using the I² test.

Results:

Our analysis included 11 observational studies with a total of 958 TBI patients. Serum PCT levels were significantly elevated on the first day of admission (0.983 ng/mL, 95% CI: 0.554–1.412), progressively decreasing over time, dropping to 0.498 (95% CI: 0.254–0.743) on day 2 and 0.358 (95% CI: 0.268–0.448) on day 3. Non-survivors had significantly higher PCT levels on day one of ICU admission (MD: 5.23 ng/mL, 95% CI: 1.26, 9.21; p=0.01). Patients who developed sepsis had significantly higher PCT levels on first day (MD: 0.21 ng/mL, 95% CI: 0.12, 0.30; p<0.0001), which remained elevated on days 2 and 5. Infected patients did not have a significantly higher PCT levels on the first day (MD: 0.05 ng/mL, 95% CI: –0.71, 0.81, p=0.68).

Conclusions:

Serum PCT levels may serve as a useful prognostic biomarker for mortality and sepsis in TBI patients, particularly during the early phase of intensive care. While PCT did not significantly predict infection, its robust association with mortality and sepsis supports its potential use in clinical decision-making for TBI patients.