Abstract
BackgroundThe prognostic value of Neutrophil-to-Lymphocyte Ratio (NLR) for the outcome of acute cervical traumatic spinal cord injury (tSCI) patients has rarely been studied by now throughout the world.MethodsWe performed a single-center retrospective cohort study to evaluate the prognostic value of NLR from peripheral whole blood count in patients with acute cervical tSCI. Patients within 6 h of acute cervical tSCI treated between Dec 2008 and May 2018 in Huashan Hospital of Fudan University were enrolled. Outcomes of patients with tSCI were assessed using American spinal injury association Impairment Scale (AIS). 6-month outcomes were dichotomized into poor outcome group (AIS A to C) and good outcome group (AIS D and E). Uni- and multivariate analyses were performed to assess the independent predictors of 6-month outcome. Two prediction models based on admission characteristics were built to evaluate the prognostic value of NLR. The discriminative ability of predictive models was evaluated using the area under the curve (AUC).ResultsA total of 377 patients were identified from our single center in China PR. Multivariate analysis showed that age, AIS grade at admission, NLR (p < 0.001) and coagulopathy (p = 0.003) were independent predictors of the 6-months outcome for acute cervical tSCI patients. The model combing NLR and standard variables (AUC = 0.944; 95% CI, 0.923–0.964) showed a more favorable prognostic value than that without NLR (AUC = 0.841; 95% CI, 0.798–0.885) in terms of 6-month outcome.ConclusionsNLR is firstly identified as an independent predictor of the 6-month outcome in acute cervical tSCI patients worldwide. The prognostic value of NLR is favorable, and a high NLR is associated with poor outcome in patients with acute cervical tSCI.
Highlights
The prognostic value of Neutrophil-to-Lymphocyte Ratio (NLR) for the outcome of acute cervical traumatic spinal cord injury patients has rarely been studied throughout the world
It was reported that high neutrophils and low lymphocytes level in the peripheral blood at admission were independently associated with poor outcome of intracerebral hemorrhage (ICH) patients, and the neutrophil-to-lymphocyte ratio (NLR) was readily available as an outcome predictor [10, 11]
Our study evaluated the prognostic value of NLR and tested its predictive power in prediction models in terms of the 6-months outcome for cervical traumatic spinal cord injury (tSCI) patients
Summary
The prognostic value of Neutrophil-to-Lymphocyte Ratio (NLR) for the outcome of acute cervical traumatic spinal cord injury (tSCI) patients has rarely been studied throughout the world. It was recognized that either primary or secondary injury was associated with the outcome of tSCI patients was considered to be [4, 5], and several standard prognostic factors at admission, including age, blood cells counts, coagulation status, Charleson Co-morbidity Index (CCI), American spinal injury association Impairment Scale (AIS) grades, and the initial Glasgow Coma Scale (GCS) score, were identified to be associated with the outcome of tSCI patients [6, 7]; their prognostic values were limited even a variety of predictive models were built. The prognostic value of NLR for the outcome of tSCI patients has rarely been studied. Whether combining NLR with standard independent predictors would improve prognostic is still unknown
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