| Objective: The correlation between preoperative blood NLR,PLR,MLR,SII and other relevant blood cell indicators,FIB,AIS classification and acute traumatic SCI was analyzed to explore the predictive value of changes in these indicators on the regression of acute traumatic SCI.Methods: A retrospective study was conducted on 77 patients with traumatic spinal cord injury(SCI)who were admitted to the trauma center and orthopedics department of our hospital from June 2019 to June 2022,with an average age of(46.09 ± 14.65)years,ranging from 42 to 84 years old.According to whether the AIS grading at the last follow-up has improved compared to the preoperative AIS grading,the patients were divided into a group with a good clinical prognosis of 49 cases,aged42 to 83 years,with an average age of(45.13 ± 13.72)years,and a group with a poor clinical prognosis of 28 cases,aged 47 to 84 years,with an average age of(47.25 ±15.16)years.All patients completed fasting blood cell analysis and coagulation factor examination,and recorded general clinical data such as age,gender,preoperative complications,preoperative AIS grade,as well as blood cell analysis indicators(NLR,SII,PLR,MLR,etc.),FIB,and other data.Chi-square test,corrected chi-square test,or Fisher’s exact test were used for categorical variables such as gender and preoperative complications.Independent sample t-test was used for continuous variables that conform to normal distribution such as PLT,HGB,and age.Nonparametric test was used for continuous variables that do not conform to normal distribution such as NLR,SII,PLR,and MLR.Univariate and multivariate logistic regression were used to determine independent predictors of acute traumatic SCI,and odds ratio(OR)and 95% confidence interval(CI)were calculated.Set p<0.05 as statistically significant.The ROC curve is plotted as a prediction indicator,and the area under the curve(AUC)is used to evaluate the predicted value.Finally,analyze the data obtained and determine the feasibility of predicting the prognosis of patients with traumatic SCI using this indicator.Results: Indicators included in the chi-square test: gender,preoperative complications,preoperative AIS grade,etc.;indicators included in the independent sample t-test: PLT,HGB,age,etc.;indicators included in the nonparametric test: NLR,SII,PLR,MLR,FIB,WBC,NEUT #,LY #,MO #,RBC.There were significant differences in preoperative AIS grading,NLR,SII,PLR,FIB,OUT #,LY #(p<0.05).Logistic regression analysis showed that the independent risk factors for poor prognosis in patients with traumatic SCI were increased NLR and preoperative AIS grade(A+B)(p<0.05),and elevated FIB was a protective factor for poor prognosis in patients with traumatic SCI(p<0.05).AUC was calculated based on the accuracy of NLR and FIB in predicting poor prognosis in patients with traumatic SCI,respectively and in combination.NLR,FIB,and combined prediction of AUC were0.755,0.727,0.827,respectively.The comparison of the respective areas between the groups suggested that the combined prediction of AUC was greater than that predicted by NLR and FIB alone(p<0.05).Conclusions: There were differences in NEUT#,LY# and FIB levels in traumatic SCI patients with good prognosis and poor prognosis at the early stage of injury.Increased NLR levels and AIS grade(A+D)are independent risk factors for poor prognosis in patients with traumatic SCI,while elevated FIB levels were protective factors for poor prognosis of traumatic SCI patients.Using NLR and FIB levels to predict poor prognosis in patients with traumatic SCI is feasible and has certain diagnostic value,which is worth further promotion. |
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