Is neutrophil-to-lymphocyte ratio a prognostic marker for traumatic brain injury in the pediatric population?

Abstract

Objective: The neutrophil-to-lymphocyte ratio (NLR) is used for the prognosis of diseases characterized by inflammatory processes. This study aims to discuss the long-term outcomes and NLR in pediatric traumatic brain injury cases.

Patients and methods: This study investigated traumatic brain injury patients younger than 18 years. Patients were grouped into 5 groups according to their Glasgow outcome scores (GOS). Initial admission Glasgow coma scale (GCS) values, neurological examinations, pupil conditions, cardiopulmonary resuscitation (CPR) administration, and seizure occurrence were recorded. Neutrophil counts and lymphocyte counts, derived from complete blood count (CBC) values taken during the patient's first 8 hours of admission, were used to calculate the NLR value.

Results: A total of 150 patients, 54 (36%) females and 96 (64%) males, were assessed in the study. The most frequent accident type was falling from a height [84 patients (56%)]. The GCS, CPR, pupillary reflex, anisocoria, surgical procedure, and neutrophil counts were significantly different between the GOS scores. There was no statistically significant difference between the GOS and the NLR (p=0.400). There was a significant difference in NLR value according to CPR, seizures, and brain injury type (p<0.05).

Conclusions: NLR values are not correlated with 1-year outcome scores in pediatric traumatic brain injury patients, unlike proven parameters such as initial GCS scores and neurological status.