Hematological markers for prediction computed tomography findings in mild traumatic brain injury

Abstract

Aims: This study aims to examine the levels of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in mild head injury (mTBI) patients to determine their predictive value for the necessity of head computed tomography (CT). Methods: mTBI patients admitted to the emergency department demographic details, levels of NLR and PLR, and outcomes from brain CT scans were evaluated. Based on the CT scan outcomes, patients were classified into two groups: one with no detectable abnormalities (group 1) and another with detected abnormalities as acute epidural hematoma, acute subdural hematoma, or subarachnoid hemorrhage (group 2). The levels of NLR and PLR were then compared across these groups. Results: In the study, out of 221 patients, 131 (59.3%) were male, and the overall mean age was 51.47±13.91 years. The most common cause of admission was traffic accidents, accounting for 70 patients (31.7%). The mean Glasgow Coma Scale score of the patients was 13.99±0.94. Group 2 consisted of 66 patients (29.9%), with 44 (66.7%) having an acute subdural hematoma, 16 (24.2%) with subarachnoid hemorrhage, and 6 (9.1%) with acute epidural hemorrhage. The mean NLR and PLR were 1.85±0.77 and 133.99±51.70, respectively. NLR values in group 2 were significantly higher than those in group 1 (p<0.000), whereas no significant difference was found in PLR values between the groups (p>0.05). The optimal cutoff value for NLR was determined to be >1.64. Conclusion: NLR levels, readily derived from standard hematological assessments, function as an objective and inflammatory biomarker. Initial NLR measurements hold the potential for forecasting abnormal findings in head CT scans associated with mTBI patients.

Keywords

• Traumatic brain injury
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• computed tomography
• mild head injury

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