Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting the 6-Month Outcome of Patients with Traumatic Brain Injury: A Retrospective Study

Zhao, Jian‐Lan; Du, Zhuoying; Yuan, Qiang; Yu, Jian; Sun, Yirui; Wu, Xing; Li, Zhiqi; Wu, Xuehai; Hu, Jin

doi:10.1016/j.wneu.2018.12.107

Cited by 33 publications

(52 citation statements)

References 27 publications

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“…In ICH patients, a high NLR at admission was associated with poor outcome, but its underlying mechanism remained unclear [11]. In the current study, cervical tSCI patients who had a higher NLR were more likely to have a poor outcome measured by AIS grade, which is consistent with results from ICH or TBI patients [12]. In addition, the level of NLR is similar with that in TBI patients, but much higher than the level in ICH patients.…”

Section: Discussionsupporting

confidence: 85%

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Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Zhao

Lai

et al. 2020

BMC Musculoskelet Disord

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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 h 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.

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Section: Discussionsupporting

confidence: 85%

“…Coagulopathy was defined as our previous studies [12,13]. Briefly, platelet counts (PLT) < 100 × 10 9 /L, international normalized ratio (INR) > 1.25, prothrombin time (PT) > 14 s, and activated partial thromboplastin time (APTT) > 36 s.…”

Section: Blood Cells Count and Demographic Datamentioning

confidence: 99%

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Zhao

Lai

et al. 2020

BMC Musculoskelet Disord

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“…Additionally, the neutrophil-to-lymphocyte count ratio (NLCR) has been suggested as a sensitive biomarker to measure the inflammatory status of the immune system in different conditions, such as malignancy [12,13], cardiovascular diseases [14], and stroke [15]. Recent studies have also suggested that NLCR is a useful marker for the prediction of clinical outcome in patients with TBI [16], with high NLCR at admission being associated with poor outcome [17,18]. Furthermore, it is well-recognized that the type and severity of TBI plays a crucial role in the activation of the inflammatory response [19,20].…”

Section: Introductionmentioning

confidence: 99%

The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients

Siwicka-Gieroba

Małodobry

Biernawska

et al. 2019

JCM

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Introduction: Neutrophil-lymphocyte count ratio (NLCR) is a simple and low-cost marker of inflammatory response. NLCR has shown to be a sensitive marker of clinical severity in inflammatory-related tissue injury, and high value of NLCR is associated with poor outcome in traumatic brain injured (TBI) patients. The purpose of this study was to retrospectively analyze NLCR and its association with outcome in a cohort of TBI patients in relation to the type of brain injury. Methods: Adult patients admitted for isolated TBI with Glasgow Coma Score lower than eight were included in the study. NLCR was calculated as the ratio between the absolute neutrophil and lymphocyte count immediately after admission to the hospital, and for six consecutive days after admission to the intensive care unit (ICU). Brain injuries were classified according to neuroradiological findings at the admission computed tomography (CT) as DAI—patients with severe diffuse axonal injury; CE—patients with hemispheric or focal cerebral edema; ICH—patients with intracerebral hemorrhage; S-EH/SAH—patients with subdural and/or epidural hematoma/subarachnoid hemorrhage. Results: NLCR was calculated in 144 patients. Admission NLCR was significantly higher in the non-survivors than in those who survived at 28 days (p < 0.05) from admission. Persisting high NLCR value was associated with poor outcome, and admission NLCR higher than 15.63 was a predictor of 28-day mortality. The highest NLCR value at admission was observed in patients with DAI compared with other brain injuries (p < 0.001). Concussions: NLCR can be a useful marker for predicting outcome in TBI patients. Further studies are warranted to confirm these results.

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“…Recently, hemogram is the most commonly, rapidly and widely available laboratory method, hence, it has been reported that NLR and PLR represent a novel composite inflammatory marker. They have been proven to correlate with CRP, as well as they have a prognostic value among patients with cancer, coronary artery disease, and some CNS diseases, such as traumatic brain injury, intracranial hemorrhage, and cerebral venous thorombosis [19][20][21][22][23], However, to be best of our knowledge, there was no study between NS and NLR. As clinically easily available biomarkers, CRP and NLR in the peripheral blood were used in our study to represent the inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Inflammation may be correlated with Symptomatic Neurosyphilis

Wu¹,

Wu²,

Huang³

et al. 2019

Preprint

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Background A retrospective study was performed to compare the differences in clinical and laboratory features of asymptomatic neurosyphilis (ANS) and symptomatic neurosyphilis. Methods One hundred and four eligible patients were enrolled from the beijing ditan hospital between February 2017 and June 2018, including 35 ANS and 69 symptomatic neurosyphilis. The clinical data was analyzed retrospectively, including age, sex, treatment history, serum Alb, neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP, RPR, rapid plasma reagin(RPR), as well as CSF RPR, CSF Alb, CSF WBCs, and CSF protein. Results Of the one hundred and four inpatients, there were significant differences in age, male, serum RPR, CSF protein, NLR, PLR, CSF-Alb /S-Alb and CRP between the two groups. The multivariate logistic regression analysis revealed that CSF protein (OR 1.07, 95%CI 1.024-1.118, P=0.002) , serum RPR (OR 1.035, 95%CI 1.001-1.059, P=0.003) and NLR (OR 2.568, 95% CI 1.226-5.376, P=0.012) were independent risk predictors for symptomatic neurosyphilis. Female (OR 0.11, 95% CI 0.025-0.490 , P=0.004) was protective factor for symptomatic neurosyphilis. Conclusions Male gender, serum RPR, CSF protein and NLR were risk factors for symptomatic neurosyphilis. They may indicate the development and aggravation of neurosyphilis Moreover, the ROC showed that NLR ≥ 3.348 could better predict the development of symptomatic neurosyphilis. Inflammation was significantly correlated with the development of neurosyphilis at discharge.

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Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting the 6-Month Outcome of Patients with Traumatic Brain Injury: A Retrospective Study

Cited by 33 publications

References 27 publications

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

Circulating neutrophil-to-lymphocyte ratio at admission predicts the long-term outcome in acute traumatic cervical spinal cord injury patients

The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients

Inflammation may be correlated with Symptomatic Neurosyphilis

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