Circulating Neutrophil-to-Lymphocyte Ratio at Admission Predicts the Long-Term Outcome in Acute Traumatic Cervical Spinal Cord Injury Patients

Abstract

Background: 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 by now throughout the world. Methods: We 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 hours 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).Results: A 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.Conclusions: NLR 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.

Systemic immune inflammation index and peripheral blood carbon dioxide concentration at admission predict poor prognosis in patients with severe traumatic brain injury

“…Few articles have conducted detailed studies on such patients. Several recent clinical studies have shown that inflammatory indicators after TBI, such as NLR and PLR, play important roles in predicting the clinical outcomes of neurotraumatic diseases (37)(38)(39)(40)(41). For example, a study by Chen et al based on 688 cases of severe head trauma showed that 508 cases (73.8%) of patients with poor prognosis 1 year after head trauma.…”

Identification of hub genes related to the innate immune response activated during spinal cord injury

“…Due to the breakdown of the blood-brain barrier after human SCI, the peripheral circulation communicates with the SCI area. When immune cells in the blood infiltrate the SCI area, the immune status in the circulating blood also changes [25,26]. The blood-brain barrier is also destroyed after SCI in mice [27,28].…”