Predictive Value Of NLR And GPR For Moderate And Severe Traumatic Brain Injury

Objective:To explore the predictive value of neutrophil lymphocyte ratio(NLR)and serum glucose-potassium ratio(GPR)in the prognosis assessment of patients with moderate or severe traumatic brain injury(TBI).Methods:A total of 106 patients with traumatic brain injury admitted to the Emergency Medicine Center of the First Hospital of Shanxi Medical University from June 2020 to June 2021 were selected according to inclusion and exclusion criteria.They were divided into good prognosis group and poor prognosis group according to the Glasgow Prognosis Scale(GOS)score 6 months after injury.There were 87 patients in the good prognosis group,including 68 males and 19 females,aged 19-85 years,with an average of(53.20±15.47)years;there were 19 patients in the poor prognosis group,including 12 males and 7 females,aged 28-84 years,with an average of(62.42±16.89)years.General data and laboratory indicators were collected between the two groups.This includes age,sex,unhealthy habits(smoking and alcohol consumption),underlying diseases(coronary heart disease,hypertension),time from injury to hospital admission,mechanism of injury,and increased intracranial pressure(defined as intracranial pressure ≥20 mm Hg),ICU admission,length of hospital stay,presence of pupil light reflection,systolic blood pressure,diastolic blood pressure,heart rate and temperature,mechanical ventilation,surgical treatment within 24 hours,absolute value of neutrophils,absolute value of lymphocytes,blood glucose,blood potassium,white blood cell count,prothrombin time,and international normalized ratio.Statistical analysis was conducted between the two groups to test whether there was statistical difference between the two groups.Multivariate logistic regression analysis was used to obtain risk factors,and receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of each risk factor for patient prognosis.Results:(1)Compared with the poor prognosis group,the good prognosis group had lower age,NLR and GPR,and the proportion of patients with pupil disappearance to light response,mechanical ventilation and operation within 24 hours after admission was lower,with statistically significant differences between the groups(P<0.05).(2)According to the results of multivariate Logistic regression analysis,NLR and GPR were risk factors for poor prognosis in moderate or severe TBI patients 6 months after injury(P<0.05).Patients with higher NLR were 1.185 times more likely to have poor prognosis than those with lower NLR(OR=1.185,95%CI: 1.028-1.366),and patients with higher GPR were 2.575 times more likely to have poor prognosis than those with lower GPR(OR=2.575,95%CI: 1.026-6.461).According to receiver operator characteristic curve(ROC curve),the area under NLR,GPR and NLR+GPR curves(AUC)are 0.747,0.792 and 0.825,respectively.Conclusion:Both NLR and GPR have certain predictive value for the prognosis of moderate or severe TBI patients,and are risk factors for poor prognosis at 6 months after injury in moderate or severe TBI patients.The higher NLR and GPR values are,the higher the possibility of poor prognosis in moderate or severe TBI patients 6 months after injury is.NLR combined with GPR has a higher predictive value for TBI patients 6 months after injury,and has greater clinical value compared with a single index.