High-sensitivity C-reactive Protein is a Predictor of Depression in Patients with Mild Traumatic Brain Injury

IntroductionDepression is one of the most common psychological problems after mild traumatic brain injury (mTBI) and affects various aspects of life quality. Previous studies demonstrated that systematic inflammation might lead to unfavorable outcomes, including depression after TBI. Therefore, we analyzed the relationship between the serum level of high sensitive C-reactive protein (hsCRP), a sensitive biomarker of systematic inflammation, and depression incidence after mTBI.MethodsWe used data from Korea’s Level-1 trauma center registry between Jan 2018 to Dec 2019. The population of our study was adult mTBI patients who visited the Level-1 trauma center using emergency medical service (EMS). We used the serum level of hsCRP measured just after arrival at the emergency department as the primary data input. The main outcome was depression evaluated 6 months after hospital discharge using the Beck depression inventory. Multivariable logistic regression analyses were performed to estimate the effect of hsCRP level on depression incidence. In addition, interaction analyses of the association between hsCRP and fever on depression incidence were performed.ResultsA total of 257 mTBI patients were enrolled. The multivariable logistic regression analysis showed that an elevated serum level of hsCRP was associated with higher odds of depression (aOR (95% CI): 1.34 (1.03—1.69)). The association was maintained only in the fever group (1.42 (1.14—1.78)).ConclusionsElevated serum level of hsCRP was associated with an increased incidence of depression 6 months after hospital discharge. This effect was maintained in the presence of fever. Our study results suggest the need for adopting strategies to prevent depression when systematic inflammation is indicated by CRP elevation and/or fever in mTBI patients.