• World Neurosurg · Apr 2019

    Prognostic Value of Neutrophil-to-Lymphocyte Ratio in predicting the 6-Month Outcome of Traumatic Brain Injury Patients: A Retrospective Study.

    • Jian-Lan Zhao, Zhuo-Ying Du, Qiang Yuan, Jian Yu, Yi-Rui Sun, Xing Wu, Zhi-Qi Li, Xue-Hai Wu, and Jin Hu.
    • Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, P.R. China.
    • World Neurosurg. 2019 Apr 1; 124: e411e416e411-e416.

    BackgroundPeripheral white blood cells are regularly analyzed on admission for patients with traumatic brain injury (TBI). The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in predicting the 6-month outcome of patients with TBI is unclear.MethodsWe designed a single-center retrospective cohort study. Patients admitted to Fudan University Huashan Hospital within 6 hours after TBI were identified between December 2004 and December 2017. The primary outcome was 6-month Glasgow Outcome Scale score. Independent predictors of 6-month outcome were assessed using uni- and multivariate analyses. Three models based on admission characteristics were built to evaluate the prognostic value of the NLR in predicting the outcome of patients with TBI. The discriminative ability of predictive models was evaluated by the area under the curve (AUC).ResultsA total of 1291 patients with TBI were included. Multivariate analysis showed age, Glasgow Coma Scale scores at admission, subdural hematoma, intraparenchymal hemorrhage, traumatic subarachnoid hemorrhage, NLR (P < 0.001), and coagulopathy (P = 0.028) were independent predictors of 6-month outcome. The model combining the NLR and standard variables (AUC = 0.936; 95% confidence interval [CI], 0.923-0.949) was more favorable in predicting 6-month outcome of patients with TBI than the model without the NLR (AUC = 0.901; 95% CI, 0.883-0.919) and the model based only on the NLR (AUC = 0.827; 95% CI, 0.802-0.852).ConclusionsNLR is an independent prognostic factor of predicting 6-month outcome of patients with TBI. A high NLR in patients with TBI is associated with poor outcome. The prognostic value of the NLR in predicting 6-month outcome of patients with TBI is favorable.Copyright © 2018 Elsevier Inc. All rights reserved.

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