Predictive value of neutrophil lymphocyte ratio in patients with postoperative intracranial infection

Abstract

Objective To explore the predictive value of dynamic changes of postoperative neutrophil lymphocyte ratio (NLR) in patients with craniocerebral trauma secondary intracranial infection. Methods One hundred sixteen patients with craniocerebral trauma secondary intracranial infection admitted to the Department of Critical Care Medicine, the Affiliated Hospital of Yangzhou University from January 2012 to December 2018 were included in the study. Patients were divided into a high NLR group (NLR≥3) and a low NLR group (NLR<3) based on the NLR measured on the third day after surgery. The difference in clinical outcome between the two groups was compared. Results NLR values were significantly higher in the high NLR group on the third postoperative day, and there was a significant statistical difference compared with the low NLR group (2.24±0.68 vs 4.72±1.21, P<0.05). In the high NLR group, 10 patients (19%) had intracranial infection, and 4 patients (6%) in the low NLR group. There was a significant statistical difference between the two groups (P=0.033). NLR: area under the curve (AUC)=0.894, 95%CI: 0.795-0.993; PCT: AUC=0.895, 95%CI: 0.764-1.027; CRP: AUC=0.898, 95%CI: 0.814-0.981. The ICU staying time and mechanical ventilation time were higher in the high NLR group than in the low NLR group. There was a statistical difference between the two groups (18.4±8.7 vs 13.2±5.4, P=0.000; 10.3±4.7 vs 5.3±4.1, P=0.000). The difference in mortality between the two groups was statistically significant. The mortality rate was higher in the high NLR group than in the low NLR group (P=0.026). Conclusion The elevated neutrophil lymphocyte ratio after surgery has a good clinical predictive value for the occurrence of intracranial infection in patients with craniocerebral trauma. The elevated NLR value is closely related to the poor prognosis. Key words: Neutrophil lymphocyte ratio; Craniocerebral trauma; Intracranial infection