Objective:

To evaluate the association of lactate-to-albumin ratio (LAR) with mortality in pediatric patients with traumatic brain injury (TBI).

Key Findings:

• Overall mortality rate was 9%.
• Non-survivors had significantly higher PRISM III scores (30 vs 3) and lower pGCS scores (3 vs 14).
• Non-survivors exhibited higher lactate levels (9.2 vs 2.5 mmol/L) and lower albumin levels (2.6 vs 4.0 g/dL).
• LAR values were significantly higher in non-survivors (4.09 vs 0.65).
• LAR demonstrated an AUC of 0.854, with a cutoff >0.68 indicating 89% sensitivity and 78% specificity.

Interpretation:

LAR at admission, alongside pGCS, is a valuable predictor of mortality in pediatric TBI patients.

Limitations:

• Single-center, retrospective design may limit generalizability.
• Small number of non-survivors could affect statistical power.
• Variability in timing of blood sampling post-injury.

Conclusion:

This study is the first to evaluate LAR as a prognostic marker in pediatric TBI, highlighting its potential role in predicting mortality.