Neutrophil-albumin ratio serves as a superior prognostic biomarker for traumatic brain injury

Li, Yuanyou; Wang, Haoxiang; Liu, Zhiyong; Deng, Ziang; Huang, Keru; Li, Gaowei; Liu, Yi; Zhou, Liangxue

doi:10.1038/s41598-024-78362-x

Sci Rep

2024

DOI: 10.1038/s41598-024-78362-x

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Neutrophil-albumin ratio serves as a superior prognostic biomarker for traumatic brain injury

Yuanyou Li,

Haoxiang Wang,

Zhiyong Liu

et al.

Abstract: Traumatic brain injury (TBI) represents a common and severe medical condition necessitating prompt risk stratification to enhance patient outcomes. Although substantial research has been conducted on the prognostic utility of various biomarkers for TBI, no single biomarker has been definitively recognized as the most precise predictor of disease outcomes. In comparison to other markers, the neutrophil-albumin ratio (NAR) has emerged as a cost-effective and reproducible inflammatory biomarker, demonstrating pot… Show more

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2024

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Cited by 2 publications

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Prognostic accuracy of blood cell count ratios in predicting adverse outcomes in crush syndrome patients

Karlidag,

Bingol,

Sarikaya

et al. 2024

Sci Rep

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The rationale behind this study was the lack of an accurate predictor to facilitate treatment management and anticipate prognosis in crush syndrome. Our research aimed to investigate the following: (1) Is there a correlation between the ratios of blood cell counts upon admission and the adverse outcomes of crush syndrome? and (2) if such a correlation exists, what are the precise thresholds of blood cell count ratios for predicting these adverse outcomes? In this single-centered and retrospective design study, we analyzed all patients admitted to our hospital after Kahramanmaras Earthquake. The data on length of stay in the ICU and mortality status were obtained using our hospital system. Ratios of blood cell count were calculated and recorded at the time of admission. The NLR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU), and patients who died. ( p < 0.001, p < 0.001 and p = 0.001, respectively). The MLR values were significantly increased in patients who underwent amputation and patients who received ICU ( p < 0.001 and p = 0.003, respectively). NAR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU), and patients who died ( p < 0.001, p < 0.001, and p = 0.002, respectively). In addition, according to binary logistic regression analysis, with a CLR value of > 109.844, the risk of amputation increases 8.188 fold; with a CLR value of > 64.518, the possibility of ICU admission requirement increases 10.117 fold, and with a CLR value of > 116.00, the risk of death increases 5.519 fold. Ratios of blood cell count such as NLR, MLR, NAR, and CLR offer a reasonable prognostic accuracy in predicting adverse outcomes and mortality in patients with crush syndrome. Therefore, for better disaster management in the future, the determination of these values at admission should be used as an adjunct tool for predicting prognosis in patients with crush syndrome. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-82035-0.

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Prognostic accuracy of blood cell count ratios in predicting adverse outcomes in crush syndrome patients

Karlidag,

Bingol,

Sarikaya

et al. 2024

Sci Rep

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Munich cCT Rule for Patients with Recreational Drug and Ethanol Poisoning

Zellner,

Wegscheider,

Dommasch

et al. 2024

JCM

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Background: Patients with recreational drug and ethanol poisoning often present with reduced consciousness, coma, or disorientation. It is often unclear if there was recent head trauma. Algorithms to perform cranial computed tomography (cCT) like the Canadian CT Head Rule (CCHR), the National Emergency X-Radiography Utilization Study Head CT Decision Instrument (NEXUS DI), or the New Orleans Criteria (NOC) exist for patients with head trauma. It is unclear whether these algorithms can be applied to this patient collective. Methods: This is a retrospective data analysis of patients admitted to our emergency department with drug or ethanol poisoning in 2019. Minors < 16 years were excluded. The primary outcome was fracture/bleeding in cCT, the secondary outcome was neurosurgical intervention. These results were calculated: 1. Sensitivity and negative predictive value (NPV) of the CCHR, NEXUS DI, and NOC. 2. Uni- and multivariate analysis of risk factors for critical findings. 3. The Munich cCT Rule sensitivity and NPV. Results: A total of 420 patients were included. cCT was performed in 120 patients. Eight patients had fracture/bleeding in cCT, two required neurosurgical intervention. The number of patients at risk, sensitivity, and NPV for critical cCT findings were as follows: CCHR 57/25%/98.3%, NEXUS DI 239/100%/100%, NOC 420/100%/100%. The sensitivity and NPV for neurosurgical intervention were as follows: CCHR 50%/99.7%, NEXUS DI 100%/100%, NOC 100%/100%. In univariate analysis, these findings correlated significantly with the following critical findings: accident, injury, injury above clavicle, head wound, anisocoria, ethanol in serum > 2 g/L, hypotension, drug ingestion, GCS < 8, focal neurological deficit, age > 60, and cerebellar symptoms. Via chi-square recursive partitioning analysis, we created the Munich cCT Rule which is positive for intoxicated patients if both an accident and an ethanol level > 2 g/L are present. This identified 70 patients at risk. It excluded fracture/bleeding and neurosurgical intervention with a sensitivity and NPV of 100%. Conclusions: Fracture/bleeding in cCT in intoxicated patients is rare. Performing unnecessary cCTs should be avoided. The Munich cCT Rule for patients with recreational drug and ethanol poisoning may help rule out critical findings and is superior to the NEXUS DI and NOC. It also has a 100% sensitivity which the CCHR (25%) is lacking.

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Neutrophil-albumin ratio serves as a superior prognostic biomarker for traumatic brain injury

Cited by 2 publications

References 31 publications

Prognostic accuracy of blood cell count ratios in predicting adverse outcomes in crush syndrome patients

Prognostic accuracy of blood cell count ratios in predicting adverse outcomes in crush syndrome patients

Munich cCT Rule for Patients with Recreational Drug and Ethanol Poisoning

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