Prognostic and diagnostic importance of the systemic immune-inflammation index in pediatric head trauma

Abstract

Head trauma is a leading cause of mortality and morbidity in pediatric patients. The trauma itself leads to the activation of a biomolecular cascade of damage. Purinergic receptors and ATP release play an important role in the activation of astroglia, microglia, monocyte-macrophages, neutrophils, and T cells in this process. The systemic immune inflammation index can be easily calculated, cheap, only requires hemogram parameters, and does not include any subjective findings. Therefore, we believe that it could be a prognostic predictor and a diagnostic marker for pediatric head trauma cases. Our study was designed as a retrospective and single-center study. The study was conducted with pediatric patients who presented to the emergency department with isolated head trauma between June 15, 2022, and December 15, 2022. Demographic data, medical history, white blood count, platelet count, neutrophil count, systemic immune inflammation index (SIII), Glasgow Coma Score, and the presence of pathology on brain computed tomography were recorded on the case report form. The study was conducted with 112 cases. In cases with bleeding, the median value of GCS was significantly lower (p<0.001), while WBC, Neutrophil, Platelet, NLR and SIII were significantly higher (p=0.008, p=0.001, p<0.001, p=0.011, and p<0.001, respectively). There was no significant difference between lymphocyte values and bleeding status. We believe that a higher SIII may be associated with persistent pericontusional inflammation in the brain and may be a good marker for predicting intracranial pathology and prognosis of the pathology caused by head trauma.