The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients
Abstract
:1. Introduction
2. Patients and Methods
2.1. ICU Protocol and Treatment
2.2. Study Protocol and Data Collection
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
BBB | blood-brain barrier |
CT | computed tomography |
DAI | diffuse axonal injury; |
CE | cerebral edema |
GCS | Glasgow Coma Score |
GOS | Glasgow Outcome Score |
ICH | intracerebral hemorrhage |
ICU | intensive care unit |
INR | international normalized ratio |
MMP | matrix metalloproteinases |
MRI | magnetic resonance imaging |
NLCR | neutrophil-lymphocyte count ratio |
S-EH/SAH | epidural and/or subdural hematoma |
TBI | trauma brain injury |
TJ | tight junctions |
WBC | white blood cell |
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Points | Clinical Condition |
---|---|
1 | Death |
2 | Vegetative state (VS) |
3 | Lower severe disability (SD-) |
4 | Upper severe disability (SD+) |
5 | Lower moderate disability (MD-) |
6 | Upper moderate disability MD+) |
7 | Lower good recovery (GR-) |
8 | Upper good recovery (GR+) |
TBI | Age | Sex | GCS | 28-Day Mortality | GOSE 6-Months Outcome | RQ | Mean GOSE |
---|---|---|---|---|---|---|---|
Total (n = 144) | 48 (IQR: 32–59) | 26 female 118 male | 5 (IQR: 3–6) | 42 patients (29.17%) | Death | 2 | 5.1 ± 2.1 |
VS | 8 | ||||||
SD- | 10 | ||||||
SD+ | 7 | ||||||
MD- | 11 | ||||||
MD+ | 7 | ||||||
GR- | 13 | ||||||
GR+ | 10 | ||||||
DAI (n = 29) | 50 (IQR: 35–57) | 4 female 25 male | 4.6 ± 1.1 | 13 patients (44.83%) | Death | 2 | 5.4 ± 1.98 |
VS | 2 | ||||||
SD- | 0 | ||||||
SD+ | 0 | ||||||
MD- | 2 | ||||||
MD+ | 2 | ||||||
GR- | 4 | ||||||
GR+ | 0 | ||||||
CE (n = 34) | 44 (IQR: 32–57) | 7 female 27 male | 5.3 ± 1.96 | 6 patients (17.65%) | Death | 0 | 4.9 ± 1.79 |
VS | 2 | ||||||
SD- | 4 | ||||||
SD+ | 0 | ||||||
MD- | 7 | ||||||
MD+ | 2 | ||||||
GR- | 4 | ||||||
GR+ | 1 | ||||||
ICH (n = 19) | 54 (IQR: 43–59) | 2 female 17 male | 4.3 ± 1.5 | 10 patients (52.63%) | Death | 0 | 3.7 ± 1.3 |
VS | 2 | ||||||
SD- | 3 | ||||||
SD+ | 2 | ||||||
MD- | 1 | ||||||
MD+ | 1 | ||||||
GR- | 0 | ||||||
GR+ | 0 | ||||||
S-EH/SAH (n = 62) | 44 (IQR: 29–60) | 10 female 52 male | 5.3 ± 1.8 | 13 patients (20.97%) | Death | 0 | 5.8 ± 2.14 |
VS | 2 | ||||||
SD- | 3 | ||||||
SD+ | 6 | ||||||
MD- | 1 | ||||||
MD+ | 2 | ||||||
GR- | 5 | ||||||
GR+ | 9 |
GOSE Scores | Day 0 | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 |
---|---|---|---|---|---|---|---|
GOSE 1 and GOSE 2 | 17.79 ± 5.7 (SEM = 1.8) | 15.92 ± 3.97 (SEM = 1.3) | 12.05 * ± 4.2 (SEM = 1.3) | 12.69 ± 7.5 (SEM = 2.4) | 11.93 ± 5.2 (SEM = 1.6) | 13.02 ± 4.8 (SEM = 1.5) | 10.11 ** ± 3.1 (SEM = 0.98) |
GOSE 3 | 13.66 ± 6.3 (SEM = 2.0) | 9.23 ± 4.2 (SEM = 1.3) | 9.23 ± 3.9 (SEM = 1.2) | 11.2 ± 6 (SEM = 1.9) | 10.06 ± 4.23 (SEM = 1.3) | 9.95 ± 3.2 (SEM = 1.0) | 8.59 ± 3.7 (SEM = 1.2) |
GOSE 4 | 9.55 ± 5.6 (SEM = 2.0) | 5.96 ± 2.4 (SEM = 0.84) | 5.23 * ± 3.6 (SEM = 1.3) | 5.59 ± 2.4 (SEM = 0.85) | 7.7 ± 4.6 (SEM = 1.6) | 6.01 ± 3.3 (SEM = 1.2) | 5.94 ± 3.2 (SEM = 1.1) |
GOSE 5 | 14.4 ± 10.8 (SEM = 3.0) | 7.12 * ± 2.8 (SEM = 0.8) | 5.54 * ± 2.1 (SEM = 0.6) | 6.03 * ± 2.2 (SEM = 0.6) | 7.51 * ± 1.8 (SEM = 0.5) | 9.52 ± 6.3 (SEM = 1.7) | 7.08 * ± 2.9 (SEM = 0.8) |
GOSE 6 | 12.77 ± 8.7 (SEM = 3.3) | 16.29 ± 19.3 (SEM = 7.2) | 11.5 ± 10.6 (SEM = 4.0) | 6.7 ± 4.97 (SEM = 1.9) | 8.23 ± 3.7 (SEM = 1.4) | 5.72 * ± 2.1 (SEM = 0.8) | 5.99 * ± 2.1 (SEM = 0.8) |
GOSE 7 | 17.9 ± 16.9 (SEM = 4.7) | 7.69 ** ± 3.9 (SEM = 1.1) | 5.47 ** ± 2.1 (SEM = 0.6) | 5.61 ** ± 2.6 (SEM = 0.7) | 5.48 ** ± 2 (SEM = 0.6) | 4.5 ** ± 1.3 (SEM = 0.4) | 5.12 ** ± 2.1 (SEM = 0.6) |
GOSE 8 | 15.53 ± 18.8 (SEM = 5.7) | 7.57 ** ± 4.9 (SEM = 1.5) | 6.47 * ± 3.6 (SEM = 1.1) | 4.98 ** ± 2.8 (SEM = 0.9) | 5.43 * ± 3.5 (SEM = 1.1) | 4.01 ** ± 1.5 (SEM = 0.5) | 4.94 * ± 2.1 (SEM = 0.6) |
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Share and Cite
Siwicka-Gieroba, D.; Malodobry, K.; Biernawska, J.; Robba, C.; Bohatyrewicz, R.; Rola, R.; Dabrowski, W. The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients. J. Clin. Med. 2019, 8, 1453. https://doi.org/10.3390/jcm8091453
Siwicka-Gieroba D, Malodobry K, Biernawska J, Robba C, Bohatyrewicz R, Rola R, Dabrowski W. The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients. Journal of Clinical Medicine. 2019; 8(9):1453. https://doi.org/10.3390/jcm8091453
Chicago/Turabian StyleSiwicka-Gieroba, Dorota, Katarzyna Malodobry, Jowita Biernawska, Chiara Robba, Romuald Bohatyrewicz, Radoslaw Rola, and Wojciech Dabrowski. 2019. "The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients" Journal of Clinical Medicine 8, no. 9: 1453. https://doi.org/10.3390/jcm8091453