Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;40(12):4251-4257.
doi: 10.1007/s00381-024-06556-9. Epub 2024 Jul 30.

Performance of the neutrophil-lymphocyte ratio as a predictor of severity and mortality in children and adolescents with traumatic brain injury

José Roberto Tude Melo  1   2 , Melina Houlis Hao Masini  3   4 , Jean Gonçalves de Oliveira  5   4 , José Carlos Esteves Veiga  6   4
Affiliations

Performance of the neutrophil-lymphocyte ratio as a predictor of severity and mortality in children and adolescents with traumatic brain injury

José Roberto Tude Melo et al. Childs Nerv Syst. 2024 Dec.

Abstract

Purpose: An inflammatory cascade associated with the systemic neutrophil response can be triggered after traumatic brain injury (TBI), causing neuronal dysfunction, which is considered to be related to the prognosis of the victims. The scope of this research is to identify the performance of the neutrophil-lymphocyte ratio (NLR) as a predictor of prognosis considering TBI severity and death as outcomes in a group of pediatric patients.

Methods: We retrospectively evaluated NLR through a consecutive review of the medical records (cross-sectional study) of children and adolescents aged < 17 years victims of TBI. To determine the highest NLR value identified as a predictor, different cutoff points were tested for each outcome. The cutoff points were defined based on the area under curve (AUC) of the receiver operating characteristic (ROC).

Results: Among the 82 children with TBI included in the sample, the performance of AUC-ROC was 0.72 when evaluating NLR as a predictor of TBI severity, with NLR cutoff point of 3, and 0.76 when considering mortality as the outcome, with an increase in the cutoff point to 11.

Conclusion: NLR can be considered a biomarker of brain injury in children and adolescent victims of TBI. Patients with NLR ≥ 3 had a fivefold higher probability of severe TBI and patients with NLR ≥ 11 experienced a ninefold higher risk of death.

Keywords: Biomarkers; Glasgow coma scale; Mortality; Predictors.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: This study was evaluated and approved by the Human Research Ethics Committee of Santa Casa de Misericórdia de São Paulo (CAAE 71721423.2.0000.5479, Opinion number 6.341.947). All procedures performed in the study involving human participants were in accordance with ethical standards of the institutional and national research and with the Helsinki Declaration and its later amendments. Consent to participate: As this is an exclusively retrospective study using medical records for data collection, no individual application of informed consent forms was necessary. In view of the design of the study, there were no new risks regarding the treatment or management of the selected cases. To avoid data leakage or breach of confidentiality, the names, photos, or images that could identify the patients were not exposed. Conflict of interest: The authors have no conflicts of interest to declare.

Similar articles

See all similar articles

Cited by

References

    1. Marchese P, Lardone C, Canepele A, Biondi S, Roggi C, Massart F, Bonuccelli A, Peroni DG, Lucifero AG, Luzzi S, Foiadelli T, Orsini A (2021) Pediatric traumatic brain injury: a new relation between outcome and neutrophil-to-lymphocyte ratio. Acta Biomed 92:e2021417. https://doi.org/10.23750/abm.v92iS4.12666 - DOI - PMC
    1. Siwicka-Gieroba D, Malodobry K, Biernawska J, Robba C, Bohatyrewicz R, Rola R, Dabrowski W (2019) The neutrophil/lymphocyte count ratio predicts mortality in severe traumatic brain injury patients. J Clin Med 8:1453. https://doi.org/10.3390/jcm8091453 - DOI - PubMed - PMC
    1. Buonacera A, Stancanelli B, Colaci M, Malatino L (2022) Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. Int J Mol Sci 23:3636. https://doi.org/10.3390/ijms23073636 - DOI - PubMed - PMC
    1. Choi SJ, Hong YH, Kim SM, Shin JY, Suh YJ, Sung JJ (2020) Hight neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis. Sci Rep 10:428. https://doi.org/10.1038/s41598-019-57366-y - DOI - PubMed - PMC
    1. Barbosa DVS, Barbosa NB, Najberg E (2016) Health regulation: challenges to the Unified Health System Governance. Cad Saude Colet 24(1):49–54. https://doi.org/10.1590/1414-462X20160001016 - DOI

LinkOut - more resources