381: PREDICTING MORTALITY IN TRAUMATIC BRAIN INJURY: COMPARISON OF NEUTROPHIL/LYMPHOCYTE RATIO AND CRASH

2020 ◽  
Vol 48 (1) ◽  
pp. 172-172
Author(s):  
Farid Sadaka ◽  
Matthew Korobey ◽  
Meghin Moynihan
2021 ◽  
Vol 11 (1) ◽  
pp. 185
Author(s):  
Yuhui Chen ◽  
Jun Tian ◽  
Bin Chi ◽  
Shangming Zhang ◽  
Liangfeng Wei ◽  
...  

Background: The incidence of coagulopathy after open traumatic brain injury (TBI) is high. Coagulopathy can aggravate intracranial hemorrhage and further increase morbidity and mortality. The purpose of this study was to determine the clinical characteristics of coagulopathy after open TBI and its relationship with the prognosis. Methods: This study retrospectively evaluated patients with isolated open TBI from December 2018 to December 2020. Coagulopathy was defined as international normalized ratio (INR) > 1.2, activated thromboplastin time (APTT) > 35 s, or platelet count <100,000/μL. We compared the relationship between the clinical, radiological, and laboratory parameters of patients with and without coagulopathy, and the outcome at discharge. Logistic regression analysis was used to evaluate the risk factors associated with coagulopathy. We then compared the effects of treatment with and without TXA in open TBI patients with coagulopathy. Results: A total of 132 patients were included in the study; 46 patients developed coagulopathy. Patients with coagulopathy had significantly lower platelet levels (170.5 × 109/L vs. 216.5 × 109/L, p < 0.001), and significantly higher INR (1.14 vs. 1.02, p < 0.001) and APTT (30.5 s vs. 24.5 s, p < 0.001) compared to those with no coagulopathy. A Low Glasgow Coma Scale (GCS) score, high neutrophil/lymphocyte ratio (NLR), low platelet/lymphocyte ratio (PLR), and hyperglycemia at admission were significantly associated with the occurrence of coagulopathy. Conclusions: Coagulopathy often occurs after open TBI. Patients with a low GCS score, high NLR, low PLR, and hyperglycemia at admission are at greater risk of coagulopathy, and therefore of poor prognosis. The efficacy of TXA in open TBI patients with coagulopathy is unclear. In addition, these findings demonstrate that PLR may be a novel indicator for predicting coagulopathy.


2020 ◽  
Vol 140 ◽  
pp. 142-147 ◽  
Author(s):  
Elham Sabouri ◽  
Alireza Majdi ◽  
Puria Jangjui ◽  
Sepideh Rahigh Aghsan ◽  
Seyed Ahmad Naseri Alavi

2020 ◽  
Vol 8 (B) ◽  
pp. 1185-1192
Author(s):  
Gede Febby Pratama Kusuma ◽  
Sri Maliawan ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi ◽  
Anak Agung Wiradewi Lestari ◽  
...  

BACKGROUND: Immune system and inflammatory response play an essential role in the development of secondary brain injury (SBI) after traumatic brain injury (TBI). An inflammatory biomarker that can reflect the SBI severity is needed to increase the effectivity of TBI management and prevent morbidity and mortality post-TBI. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are more affordable than C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), theoretically have the potential to be used as a marker of the SBI severity. However, NLR and PLR in daily medical practice are not yet fully utilized. AIM: The aim of the study was to correlate NLR and PLR with CRP and ESR as a marker of SBI severity post-TBI. METHODS: This cross-sectional study was conducted at Sanglah Hospital Denpasar from January to April 2020. Patients diagnosed with TBI were included in this study by consecutive sampling. The blood samples were taken at 24-h post-TBI to obtain the NLR, PLR, CRP, and ESR results. Spearman’s correlation test was conducted to determine the correlation between NLR and PLR with CRP and ESR. RESULTS: Eighty-five patients were included in data analysis. Median ± (interquartile range) of the NLR, PLR, CRP, and ESR were 7.60 ± (6.83), 145.58 ± (76.95), 60.83 ± (66.3), and 12.50 ± (13.85) consecutively. NLR and PLR had a significant positive correlation with CRP (r = 0.472, **p < 0.01; r = 0.283, **p < 0.01 consecutively). But, NLR and PLR were not correlated with ESR. CONCLUSION: NLR and PLR can become a useful and more affordable marker for reflecting the SBI severity in acute TBI.


2021 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Tamajyoti Ghosh ◽  
Subir Dey

Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer.Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve.Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 hr) of > 9.6 (AUC=0.931) with a p value of <0.001 with sensitivity of 100% and specificity of 79.27% and peak NLCR (48 hrs) of >12.4 (AUC= 0.973) with a p value of <0.001 with sensitivity of 100% and specificity of 89.02% were associated with unfavourable outcome.Conclusions: High NLCR and initial poor GCS are independent unfavourable prognostic factors in 1 month GOS following severe traumatic head injury.


2020 ◽  
Vol 193 ◽  
pp. 105772 ◽  
Author(s):  
Rebekah Kimball ◽  
Elad Shachar ◽  
Stephanie Eyerly-Webb ◽  
Daxa M. Patel ◽  
Heather Spader

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