Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting the 6-Month Outcome of Patients with Traumatic Brain Injury: A Retrospective Study
Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting the 6-Month Outcome of Patients with Traumatic Brain Injury: A Retrospective Study
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中性粒细胞与淋巴细胞比率对预测脑外伤患者 6 个月预后的预后价值：一项回顾性研究
DOI：
10.1016/j.wneu.2018.12.107
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发表时间：
2019-04-01
影响因子：
2
通讯作者：
Hu, Jin
中科院分区：
文献类型：
--
作者：
Zhao, Jian-Lan;Du, Zhuo-Ying;Hu, Jin
背景：创伤性脑损伤（TBI）患者入院时定期分析外周白色血细胞。嗜中性粒细胞与淋巴细胞比率（NLR）在预测TBI患者6个月预后中的预后价值尚不清楚。2004年12月至2017年12月期间，确定了复旦大学华山医院TBI后6小时内收治的患者。主要结局为6个月格拉斯哥结局量表评分。采用单因素和多因素分析评估6个月预后的独立预测因素。建立了三个基于入院特征的模型，以评估NLR在预测TBI患者预后中的预后价值。结果：共纳入1291例TBI患者，其中1291例为TBI患者，1291例为TBI患者，1291例为TBI患者。多变量分析显示年龄、入院时格拉斯哥昏迷评分、硬膜下血肿、脑实质内出血、外伤性蛛网膜下腔出血、NLR（P < 0.001）和凝血功能障碍（P = 0.028）是6个月预后的独立预测因素。结合NLR和标准变量的模型（AUC = 0.936; 95%置信区间[CI]，0.923-0.949）在预测TBI患者的6个月结局方面比无NLR的模型更有利（AUC = 0.901，95%CI，0.883-0.919）和仅基于NLR的模型（AUC = 0.827，95%CI，0.802-0.852）。TBI患者的高NLR与不良结局相关。NLR在预测TBI患者6个月预后方面的预后价值是有利的。
BACKGROUND: Peripheral white blood cells are regularly analyzed on admission for patients with traumatic brain injury (TBI). The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in predicting the 6-month outcome of patients with TBI is unclear.METHODS: We designed a single-center retrospective cohort study. Patients admitted to Fudan University Huashan Hospital within 6 hours after TBI were identified between December 2004 and December 2017. The primary outcome was 6-month Glasgow Outcome Scale score. Independent predictors of 6-month outcome were assessed using uni- and multivariate analyses. Three models based on admission characteristics were built to evaluate the prognostic value of the NLR in predicting the outcome of patients with TBI. The discriminative ability of predictive models was evaluated by the area under the curve (AUC).RESULTS: A total of 1291 patients with TBI were included. Multivariate analysis showed age, Glasgow Coma Scale scores at admission, subdural hematoma, intraparenchymal hemorrhage, traumatic subarachnoid hemorrhage, NLR (P < 0.001), and coagulopathy (P = 0.028) were independent predictors of 6-month outcome. The model combining the NLR and standard variables (AUC = 0.936; 95% confidence interval [CI], 0.923-0.949) was more favorable in predicting 6-month outcome of patients with TBI than the model without the NLR (AUC = 0.901; 95% CI, 0.883-0.919) and the model based only on the NLR (AUC = 0.827; 95% CI, 0.802-0.852).CONCLUSIONS: NLR is an independent prognostic factor of predicting 6-month outcome of patients with TBI. A high NLR in patients with TBI is associated with poor outcome. The prognostic value of the NLR in predicting 6-month outcome of patients with TBI is favorable.