Dynamics of neutrophil-to-lymphocyte ratio can be associated with clinical outcomes of children with moderate to severe traumatic brain injury: A retrospective observational study

•Post-traumatic alteration of the immune system plays important roles in the initiation and development of secondary brain damage.•The changes in neutrophil-to-lymphocyte ratio (delta NLR) can be a predictor of poor clinical outcome of pediatrics with moderate to severe traumatic brain injury (TBI)....

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Published in:Injury 2022-03, Vol.53 (3), p.999-1004
Main Authors: Alimohammadi, Ehsan, Foroushani, Alireza Zamani, Moradi, Farid, Ebrahimzadeh, Kaveh, Nadersepahi, Mohammad Javad, Asadzadeh, Sahel, Amiri, Akram, Hosseini, Sahar, Eden, Sonia V, Bagheri, Seyed Reza
Format: Article
Language:English
Subjects:
Brain Injuries, Traumatic - therapy
Child
Female
Glasgow outcome scale
Humans
Lymphocytes
Male
Neutrophil-to-lymphocyte ratio
Neutrophils
Prognosis
Retrospective Studies
Traumatic brain injury
Treatment Outcome
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Summary:•Post-traumatic alteration of the immune system plays important roles in the initiation and development of secondary brain damage.•The changes in neutrophil-to-lymphocyte ratio (delta NLR) can be a predictor of poor clinical outcome of pediatrics with moderate to severe traumatic brain injury (TBI).•Delta NLR, as a cost-effective and easily available biomarker, could be used to predict clinical outcomes in these patients. The neutrophil to lymphocyte ratio (NLR) has been reported to be associated with clinical outcomes of patients with severe traumatic brain injury (TBI). This study aimed to evaluate the correlation between the dynamics of NLR and clinical outcomes of pediatric patients with moderate to severe TBI. We retrospectively evaluated the clinical data of a total of 374 pediatric patients with moder-ate to severe TBI who were treated in our department between May 2016 and May 2020. Clinical and laboratory data including the NLR upon admission and the NLR on hospital day four were collected. Poor clinical outcome was defined as Glasgow Outcome Scale (GOS) of 1–3. Multivariable logistic regression analyses were performed to investigate the correlation between the dynamics of NLR and clinical outcome. Three hundred seventy-four pediatric patients (mean age 7.37 ± 3.11, 52.7% male) were evaluated. Based on the ROC curves, a value of 5 was determined as the NLR cut-off value. The corresponding cutoff value for delta NLR was 1. The Glasgow Coma Scale (GCS) (OR, 3.42; 95% CI: 1.88–5.28; P
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2021.09.052