The prognostic values of neutrophil to lymphocyte ratio in traumatically injured patients upon admission: A mini-Review

Abstract

Subsequent to trauma and systemic inflammatory response syndrome, the typical reaction is an enhancement of the total white blood cell count. Neutrophils are abundant circulating leukocytes in humans that play a crucial role in initial immune response against invading microbes through phagocytosis and exerting inflammatory mediators. However, lymphocytes are the main cellular compartments of the immune system that are negatively affected in the setting of trauma. The neutrophil to lymphocyte ratio (NLR), which can be easily measured in daily clinical practices, is an alternative marker of inflammation before any clinical findings can be observed. Therefore, in this mini-review study, we briefly discussed recent evidence on NLR variations at the time of hospitalization and its prognostic values in trauma patients. Most investigations declared high values of NLR potentially have a poor prognosis in traumatically ill patients on admission and contribute to coagulopathy, increased hospitalization and mortality. Moreover, given that various cut-off points have been considered for the NLR value, receiving a unique one and linking with subsequent outcomes of the disease should be in ongoing researches.

Relationship between neutrophil to lymphocyte ratio and diabetic peripheral neuropathy: a systematic review and meta-analysis

“…The loss in blood supply to local tissues is exacerbated by increased blood viscosity and blood flow disturbances. Ischemia and hypoxia of nerve tissues are caused by this process, which stimulates the production of cytokines and worsens inflammatory damage [14].…”

“…In vivo, the NLR represents the equilibrium between neutrophils and lymphocytes. Inflammatory reactions are tightly linked to neutrophils, and immunological regulatory pathways are reflected in lymphocytes [14,44]. Neutrophils can represent systemic inflammation, as well as innate immune responses (mediated by neutrophils) and lymphocytes can represent adaptive immunological responses (mediated by lymphocytes) [45,46].…”

“…The association between diabetic neuropathy and inflammation is well established [8]. Besides, NLR is increased in conditions that characterized with inflammation, such as gastrointestinal diseases [9], cardiac conditions [10], thyroiditis [11], and other thyroid conditions [12], irritable bowel disease [13], trauma [14], and Covid-19 infection [15]. Thus, analyzing the relationship between NLR and diabetic neuropathy makes sense.…”