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

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI:10.1007/s00381-024-06556-9
José Roberto Tude Melo, Melina Houlis Hao Masini, Jean Gonçalves de Oliveira, José Carlos Esteves Veiga
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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.

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中性粒细胞-淋巴细胞比值作为预测儿童和青少年脑外伤严重程度和死亡率的指标。
目的:创伤性脑损伤(TBI)后可引发与全身中性粒细胞反应相关的炎症级联反应,导致神经元功能障碍,这被认为与受害者的预后有关。本研究的目的是确定中性粒细胞-淋巴细胞比值(NLR)作为预后预测指标的性能,并将创伤性脑损伤严重程度和死亡作为一组儿科患者的预后结果:方法:我们通过连续审查儿童和青少年的病历(横断面研究)对 NLR 进行了回顾性评估:在样本中的82名创伤性脑损伤患儿中,当评估NLR作为创伤性脑损伤严重程度的预测指标时,AUC-ROC的表现为0.72,NLR截断点为3;当考虑死亡率作为结果时,AUC-ROC的表现为0.76,截断点增加到11:结论:NLR可被视为儿童和青少年创伤性脑损伤患者脑损伤的生物标志物。结论:NLR≥3的患者发生严重创伤性脑损伤的概率高出5倍,NLR≥11的患者死亡风险高出9倍。
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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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Correction: Imaging features of pediatric meningiomas: emphasis on unusual locations. Correction: Occipital encephalocele: a retrospective analysis and assessment of post-surgical neurodevelopmental outcome. Radiographic severity is associated with worse executive function in metopic craniosynostosis. Occipital encephalocele: a retrospective analysis and assessment of post-surgical neurodevelopmental outcome. Vaulting further: cranial vault expansion for craniocerebral disproportion without primary craniosynostosis.
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