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Abstract：
Neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) have been identified as potential prognostic markers in various conditions, including cancer, cardiovascular disease, and stroke. This study aims to investigate the dynamic changes of NLR and MLR following cerebral contusion and their associations with six-month outcomes.
Retrospective data were collected from January 2016 to April 2020, including patients diagnosed with cerebral contusion and discharged from two teaching-oriented tertiary hospitals in Southern China. Patient demographics, clinical manifestations, laboratory test results (neutrophil, monocyte, and lymphocyte counts) obtained at admission, 24 hours, and one week after cerebral contusion, as well as outcomes, were analyzed. An unfavorable outcome was defined as a Glasgow Outcome Score (GOS) of 0-3 at six months. Logistic regression analysis was performed to identify independent predictors of prognosis, while receiver characteristic curve analysis was used to determine the optimal cutoff values for NLR and MLR.
A total of 552 patients (mean age 47.40, SD 17.09) were included, with 73.19% being male. Higher NLR at one-week post-cerebral contusion (adjusted OR = 4.19, 95%CI, 1.16 - 15.16, P = 0.029) and higher MLR at admission and at 24 h (5.80, 1.40 - 24.02, P = 0.015; 9.06, 1.45 - 56.54, P = 0.018, respectively) were significantly associated with a 6-month unfavorable prognosis after adjustment for other risk factors by multiple logistic regression. The NLR at admission and 24 hours, as well as the MLR at one week, were not significant predictors for a 6-month unfavorable prognosis. Based on receiver operating characteristic curve analysis, the optimal thresholds of NLR at 1 week and MLR at admission after cerebral contusion that best discriminated a unfavorable outcome at 6-month were 6.39 (81.60% sensitivity and 70.73% specificity) and 0.76 (55.47% sensitivity and 78.26% specificity), respectively.
NLR measured one week after cerebral contusion and MLR measured at admission may serve as predictive markers for a 6-month unfavorable prognosis. These ratios hold potential as parameters for risk stratification in patients with cerebral contusion, complementing established biomarkers in diagnosis and treatment. However, further prospective studies with larger cohorts are needed to validate these findings.
Retrospective data were collected from January 2016 to April 2020, including patients diagnosed with cerebral contusion and discharged from two teaching-oriented tertiary hospitals in Southern China. Patient demographics, clinical manifestations, laboratory test results (neutrophil, monocyte, and lymphocyte counts) obtained at admission, 24 hours, and one week after cerebral contusion, as well as outcomes, were analyzed. An unfavorable outcome was defined as a Glasgow Outcome Score (GOS) of 0-3 at six months. Logistic regression analysis was performed to identify independent predictors of prognosis, while receiver characteristic curve analysis was used to determine the optimal cutoff values for NLR and MLR.
A total of 552 patients (mean age 47.40, SD 17.09) were included, with 73.19% being male. Higher NLR at one-week post-cerebral contusion (adjusted OR = 4.19, 95%CI, 1.16 - 15.16, P = 0.029) and higher MLR at admission and at 24 h (5.80, 1.40 - 24.02, P = 0.015; 9.06, 1.45 - 56.54, P = 0.018, respectively) were significantly associated with a 6-month unfavorable prognosis after adjustment for other risk factors by multiple logistic regression. The NLR at admission and 24 hours, as well as the MLR at one week, were not significant predictors for a 6-month unfavorable prognosis. Based on receiver operating characteristic curve analysis, the optimal thresholds of NLR at 1 week and MLR at admission after cerebral contusion that best discriminated a unfavorable outcome at 6-month were 6.39 (81.60% sensitivity and 70.73% specificity) and 0.76 (55.47% sensitivity and 78.26% specificity), respectively.
NLR measured one week after cerebral contusion and MLR measured at admission may serve as predictive markers for a 6-month unfavorable prognosis. These ratios hold potential as parameters for risk stratification in patients with cerebral contusion, complementing established biomarkers in diagnosis and treatment. However, further prospective studies with larger cohorts are needed to validate these findings.
摘要：
■中性粒细胞与淋巴细胞比率（NLR）和单核细胞与淋巴细胞比率（MLR）已被确定为各种情况下的潜在预后标志物，包括癌症,心血管疾病,和中风。本研究旨在探讨脑挫裂伤后NLR和MLR的动态变化及其与6个月预后的关系。
■回顾性数据收集于2016年1月至2020年4月，包括华南地区两家教学型三级医院诊断为脑挫裂伤并出院的患者。患者人口统计学，临床表现，实验室检查结果(中性粒细胞，单核细胞,和淋巴细胞计数）在入院时获得，24小时,脑挫伤一周后,以及结果，进行了分析。不利结果定义为在六个月时格拉斯哥结果评分（GOS）为0-3。进行Logistic回归分析以确定预后的独立预测因子。而受试者特征曲线分析用于确定NLR和MLR的最佳截止值。
■共包括552名患者（平均年龄47.40，SD17.09），73.19%是男性。脑挫裂伤后1周NLR较高（校正后OR=4.19，95CI，1.16-15.16，P=0.029）和入院时和24hMLR较高（分别为5.80，1.40-24.02，P=0.015；9.06，1.45-56.54，P=0.018）与其他危险因素校正后6个月的不良预后显着相关。入院时的NLR和24小时，以及一周的MLR，并不是6个月预后不良的显著预测因子。基于接收机工作特性曲线分析,大脑挫伤后1周时的NLR和入院时的MLR的最佳阈值是6.39(81.60%的敏感性和70.73%的特异性)和0.76(55.47%的敏感性和78.26%的特异性),分别。
■脑挫伤后一周测量的NLR和入院时测量的MLR可以作为6个月不良预后的预测指标。这些比率有可能作为脑挫裂伤患者危险分层的参数，在诊断和治疗中补充已建立的生物标志物。然而,我们需要更多的前瞻性研究来验证这些发现.
■回顾性数据收集于2016年1月至2020年4月，包括华南地区两家教学型三级医院诊断为脑挫裂伤并出院的患者。患者人口统计学，临床表现，实验室检查结果(中性粒细胞，单核细胞,和淋巴细胞计数）在入院时获得，24小时,脑挫伤一周后,以及结果，进行了分析。不利结果定义为在六个月时格拉斯哥结果评分（GOS）为0-3。进行Logistic回归分析以确定预后的独立预测因子。而受试者特征曲线分析用于确定NLR和MLR的最佳截止值。
■共包括552名患者（平均年龄47.40，SD17.09），73.19%是男性。脑挫裂伤后1周NLR较高（校正后OR=4.19，95CI，1.16-15.16，P=0.029）和入院时和24hMLR较高（分别为5.80，1.40-24.02，P=0.015；9.06，1.45-56.54，P=0.018）与其他危险因素校正后6个月的不良预后显着相关。入院时的NLR和24小时，以及一周的MLR，并不是6个月预后不良的显著预测因子。基于接收机工作特性曲线分析,大脑挫伤后1周时的NLR和入院时的MLR的最佳阈值是6.39(81.60%的敏感性和70.73%的特异性)和0.76(55.47%的敏感性和78.26%的特异性),分别。
■脑挫伤后一周测量的NLR和入院时测量的MLR可以作为6个月不良预后的预测指标。这些比率有可能作为脑挫裂伤患者危险分层的参数，在诊断和治疗中补充已建立的生物标志物。然而,我们需要更多的前瞻性研究来验证这些发现.
