Platelet-to-lymphocyte ratio predicts short-term mortality in patients with moderate to severe traumatic brain injury

Abstract

An easily accessible biomarker with good diagnostic power for patients with traumatic brain injury (TBI) was needed to predict the short-term mortality. Studies have shown that platelet-to-lymphocyte ratio (PLR) is a biomarker for patients with tumor. This study aimed to identify the relationship between PLR and short-term mortality in patients with moderate to severe TBI. This is a retrospective cohort study. We selected patients with moderate to severe TBI who were admitted to the emergency department of The First Affiliated Hospital of Zhengzhou University. Biomarkers were collected within 24 h after admission. To investigate their relationship with short-term mortality, Cox proportional hazards regression and ROC curve analysis were performed. A total number of 170 patients was included. 47 (27.6%) patients had died and 123 (72.4%) patients were survived by the end of the study. Patients with different Rotterdam CT score (HR = 1.571, 95%CI 1.232–2.002, p < 0.001) or PLR levels (HR = 1.523, 95%CI 1.110–2.090, p = 0.009) had significant different mortality rates. The AUC curve analysis showed that the AUC of Rotterdam CT score and PLR groups were 0.729 (95%CI 0.638–0.821, p < 0.001) and 0.711 (95%CI 0.618–0.803 p < 0.001), respectively. PLR level is an independent biomarker with great diagnostic power for short-term mortality in patients with moderate to severe brain injury.

Platelet-to-lymphocyte ratio as a prognostic predictive marker on adults with traumatic brain injury: Systematic review

“…A retrospective study by Li and Deng (2022) in 170 patients with moderate-to-severe TBI assessed the prognostic ability of the PLR and Rotterdam computed tomography score on the patients' mortality rate. It was found that PLR can be an independent biomarker with a good level of prognostic ability in short-term mortality (30-day mortality), with hazard risk = 1.523 (95% confidence interval [CI] 1.110-2.090, P = 0.009) and area under the curve (AUC) 0.711 (95% CI 0.618-0.803, P < 0.001).…”

“…[3,31] At sites of injury, damaged cells release factors that trigger the inflammatory cascade, along with chemokines and growth factors, which will attract neutrophils, monocytes, lymphocytes, and mast cells to the injury site. [14,25] Studies have demonstrated that a considerable number of indicators may be found in cerebrospinal fluid after TBI, indicating that neuroinflammation is one of the key causes of subsequent damage in TBI. e identification of these markers, however, has a high technological and financial need.…”

“…e identification of these markers, however, has a high technological and financial need. [10,25] Complete blood counts are a simple, low-cost standard examination procedure that provides doctors with information about a patient's blood composition and characteristics, such as platelet-lymphocyte ratio (PLR), associated with systemic nonspecific inflammation. [3,27] In multiple studies, elevated PLR was associated with a worse prognosis for non-small-cell lung cancer and colorectal cancer.…”

The Clinical Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Predicting Hematoma Expansion and Poor Outcomes in Patients with Acute Intracerebral Hemorrhage

“…However, some studies have shown contradicting perspectives of a negative association between higher PLR and worse outcomes. An observational study (n = 170) reported that lower PLR could be an independent factor for higher survival in patients with traumatic brain injury [41]. That phenomenon explains that spontaneous aggregation and excessive platelet consumption after brain injury induce platelet depletion, thereby breaking the balance of coagulation and anticoagulation, enhancing bleeding risk.…”

Role of platelet-to-lymphocyte ratio at the time of arrival to the emergency room as a predictor of short-term mortality in trauma patients with severe trauma team activation

“…It has been identified as a prognostic predictor in patients with cancer, cardiovascular diseases, pulmonary diseases, and sepsis [ 8 - 11 ]. Trauma-related research has reported the utility of PLR as a prognostic predictor for organ damage, such as abdominal trauma and brain injury [ 12 , 13 ]. A significant correlation between PLR and patient prognosis for the aforementioned diseases and trauma has been reported.…”