Cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic biomarker for postoperative intracranial infections in patients with acute brain injury: a prospective diagnostic accuracy study.

内容摘要

The aim of this study was to evaluate the diagnostic accuracy of the cerebrospinal fluid glucose-to-lactate ratio (CGLR) for detecting postoperative intracranial infections in patients with acute brain injury (ABI) and compare it with conventional biomarkers. A single-center prospective study was conducted with 121 postoperative ABI patients suspected of infection. Cerebrospinal fluid (CSF) and peripheral blood samples were collected under aseptic conditions. Levels of CSF lactate (cLac), CSF glucose (cGlu), CSF procalcitonin (PCT), and CGLR were measured. The AUC values for cGlu and cLac were 0.836 and 0.820, respectively, with optimal cutoffs of 2.6 mmol⋅L-1 for cGlu and 4.5 mmol⋅L-1 for cLac. The combined metric, CGLR, demonstrated a higher diagnostic performance (AUC = 0.866) with an optimal cutoff of 0.61. CGLR values were similar between hyperglycemic and normoglycemic patients, regardless of infection status (all P > 0.05). The diagnostic performance of CGLR was consistent across SAH, ICH, and TBI patient cohorts (all P > 0.05). CGLR is a rapid, cost-effective, and reliable biomarker for diagnosing postoperative intracranial infections in ABI patients. It outperforms traditional markers and remains unaffected by peripheral glucose fluctuations.