Peak Neutrophil-to-Lymphocyte Ratio Correlates with Clinical Outcomes in Patients with Severe Traumatic Brain Injury.

Abstract

Studies suggested that the neutrophil-to-lymphocyte ratio (NLR) was associated with unfavorable outcomes in different diseases such as intracerebral hemorrhage, cardiovascular problem, cancer, and severe traumatic brain injury (sTBI). We aimed to evaluate the relationship between peak NLR and 1-year outcomes in patients with sTBI. We retrospectively reviewed the clinical data of patients with sTBI who were treated in our department between January 2013 and January 2017. NLRs between day 1 and day 12 after admission as well as other related indicators were collected. The relationship between peak NLR and 1-year outcomes was analyzed. Factors associated with larger peak NLR were also explored. A total of 316 patients were included, and 81.3% (257/316) experienced unfavorable outcomes. Peak NLR was identified as an independent predictor for unfavorable outcomes after sTBI in multivariable logistic regression analysis (odds ratio, 1.086; 95% confidence interval, 1.037-1.137; P < 0.001). Its predictive value was confirmed by receiver operating characteristic analysis (area under curve = 0.775; P < 0.001). The day 1 NLR as well as admission Glasgow Coma Scale score was independently correlated with increased peak NLR. Peak NLR was associated with the clinical prognosis after sTBI and was a promising predictor for 1-year outcomes.