Prognostic value of platelet-to-lymphocyte ratio in predicting the 6-month outcome of patients with traumatic brain injury

doi:10.3877/cma.j.issn.2095-9141.2022.03.004

Abstract

Abstract:

Objective

To investigate the value of platelet-to-lymphocyte ratio (PLR) for predicting the 6-month outcome of patients with traumatic brain injury (TBI).

Methods

The clinical data of 346 TBI patients who were admitted to the Neurosurgery Department of Fuyang Fifth People’s Hospital of Anhui Province from January 2017 to February 2021 were retrospectively reviewed. The patients were divided into a poor prognosis group (GOS-E score ≤ 4 points) and a good prognosis group (GOS-E score 5-8 points) according to GOS-E progonosis scores at 6 months after discharge. Univariate and multivariate Logistic regression analyses were used to assess the risk factors of poor prognosis. Three predictive models based on admission characteristics were built with receiver operating characteristic (ROC) curve and area under the curve (AUC) to evaluate the prognostic value of the PLR in predicting the 6-month outcome of patients with TBI.

Results

Of 346 TBI patients, 280 patients had a good prognosis (good prognosis group) and 66 patients had a poor prognosis (poor prognosis group). The results of univariate and multivariate Logistic regression analysis showed that advanced age, low GCS score at admission, high leukocyte count, low platelet count and low PLR were independent risk factors for prognosis in patients with TBI. ROC curve analysis showed that the model combining the PLR and standard variables (AUC=0.957, 95%CI: 0.931-0.976) was more favorable in predicting 6-month outcome of patients with TBI.

Conclusion

The level of PLR at admission has great predictive value for 6-month prognosis of patients with TBI in 6 months.

Key words: Traumatic brain injury, Platelet-to-lymphocyte ratio, Prognosis

Shen Wang, Xuxu Xu, Ruhai Wang. Prognostic value of platelet-to-lymphocyte ratio in predicting the 6-month outcome of patients with traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(03): 150-154.

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Figures/Tables 6

References 20

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影响因素		预后良好组(n=280)	预后不良组(n=66)	χ²/t/U值	P值
年龄（岁，±s）		56.08±16.77	63.15±15.00	-3.144	0.002
性别（男/女）		189/91	43/23	0.133	0.715
入院时GCS评分[例(%)]				144.506	<0.001
	3~8分	29(10.4)	53(80.3)
	9~15分	251(89.6)	13(19.7)
致伤机制[例(%)]				1.046	0.593
	跌倒	172(61.4)	39(59.1)
	交通事故	98(35.0)	26(39.4)
	其他	10(3.6)	1(1.5)
合并多发伤[例(%)]		89(31.8)	28(42.4)	2.701	0.100
合并高血压[例(%)]		72(25.7)	22(33.3)	1.567	0.211
合并烟酒史[例(%)]		23(8.2)	10(15.2)	2.979	0.084
实验室检查
	白细胞计数[10⁹/L，M(P₂₅，P₇₅)]	11.31(8.87,13.87)	11.83(9.68,18.76)	-2.287	<0.001
	中性粒细胞[10⁹/L，M(P₂₅，P₇₅)]	9.31(6.74,12.32)	9.38(7.15,15.57)	-1.313	0.003
	淋巴细胞[10⁹/L，M(P₂₅，P₇₅)]	1.07(0.76,1.54)	1.21(0.77,2.99)	-1.867	<0.001
	血红蛋白[g/L，M(P₂₅，P₇₅)]	132(119.00,145.00)	128(111.75,141.25)	-1.787	0.074
	血小板计数[10⁹/L，M(P₂₅，P₇₅)]	178.50(147.00,217.00)	164.50(126.00,189.25)	-2.632	0.008
	血小板-中性粒细胞比值[M(P₂₅，P₇₅)]	18.69(13.38,27.73)	15.88(9.38,23.01)	-3.222	0.001
	中性粒细胞-淋巴细胞比值[M(P₂₅，P₇₅)]	9.15(4.75,15.29)	9.38(3.51,17.16)	-0.005	0.996
	血小板-淋巴细胞比值[M(P₂₅，P₇₅)]	156.69(112.53,227.67)	118.92(60.68,190.14)	-3.527	<0.001
	血小板-白细胞比值[M(P₂₅，P₇₅)]	15.57(11.57,21.28)	12.77(8.18,16.22)	-4.347	<0.001
	白蛋白[g/L，M(P₂₅，P₇₅)]	39.30(36.13,42.10)	33.55(30.10,37.94)	-5.963	<0.001
	前白蛋白（mg/L，±s）	200.28±53.90	172.30±51.28	3.828	<0.001
	凝血酶原时间[s，M(P₂₅，P₇₅)]	11.60(10.70,12.18)	12.15(11.60,13.90)	-4.616	<0.001
	活化部分凝血活酶时间[s，M(P₂₅，P₇₅)]	27.60(25.70,29.60)	27.95(25.48,30.85)	-0.667	0.008
	国际标准化比值[M(P₂₅，P₇₅)]	1.03(0.95,1.08)	1.07(1.02,1.24)	-4.290	<0.001
	D-二聚体[mg/L，M(P₂₅，P₇₅)]	13.32(7.31,13.32)	13.32(6.69,19.02)	-2.543	<0.001

影响因素		预后良好组(n=280)	预后不良组(n=66)	χ²/t/U值	P值
年龄（岁，±s）		56.08±16.77	63.15±15.00	-3.144	0.002
性别（男/女）		189/91	43/23	0.133	0.715
入院时GCS评分[例(%)]				144.506	<0.001
	3~8分	29(10.4)	53(80.3)
	9~15分	251(89.6)	13(19.7)
致伤机制[例(%)]				1.046	0.593
	跌倒	172(61.4)	39(59.1)
	交通事故	98(35.0)	26(39.4)
	其他	10(3.6)	1(1.5)
合并多发伤[例(%)]		89(31.8)	28(42.4)	2.701	0.100
合并高血压[例(%)]		72(25.7)	22(33.3)	1.567	0.211
合并烟酒史[例(%)]		23(8.2)	10(15.2)	2.979	0.084
实验室检查
	白细胞计数[10⁹/L，M(P₂₅，P₇₅)]	11.31(8.87,13.87)	11.83(9.68,18.76)	-2.287	<0.001
	中性粒细胞[10⁹/L，M(P₂₅，P₇₅)]	9.31(6.74,12.32)	9.38(7.15,15.57)	-1.313	0.003
	淋巴细胞[10⁹/L，M(P₂₅，P₇₅)]	1.07(0.76,1.54)	1.21(0.77,2.99)	-1.867	<0.001
	血红蛋白[g/L，M(P₂₅，P₇₅)]	132(119.00,145.00)	128(111.75,141.25)	-1.787	0.074
	血小板计数[10⁹/L，M(P₂₅，P₇₅)]	178.50(147.00,217.00)	164.50(126.00,189.25)	-2.632	0.008
	血小板-中性粒细胞比值[M(P₂₅，P₇₅)]	18.69(13.38,27.73)	15.88(9.38,23.01)	-3.222	0.001
	中性粒细胞-淋巴细胞比值[M(P₂₅，P₇₅)]	9.15(4.75,15.29)	9.38(3.51,17.16)	-0.005	0.996
	血小板-淋巴细胞比值[M(P₂₅，P₇₅)]	156.69(112.53,227.67)	118.92(60.68,190.14)	-3.527	<0.001
	血小板-白细胞比值[M(P₂₅，P₇₅)]	15.57(11.57,21.28)	12.77(8.18,16.22)	-4.347	<0.001
	白蛋白[g/L，M(P₂₅，P₇₅)]	39.30(36.13,42.10)	33.55(30.10,37.94)	-5.963	<0.001
	前白蛋白（mg/L，±s）	200.28±53.90	172.30±51.28	3.828	<0.001
	凝血酶原时间[s，M(P₂₅，P₇₅)]	11.60(10.70,12.18)	12.15(11.60,13.90)	-4.616	<0.001
	活化部分凝血活酶时间[s，M(P₂₅，P₇₅)]	27.60(25.70,29.60)	27.95(25.48,30.85)	-0.667	0.008
	国际标准化比值[M(P₂₅，P₇₅)]	1.03(0.95,1.08)	1.07(1.02,1.24)	-4.290	<0.001
	D-二聚体[mg/L，M(P₂₅，P₇₅)]	13.32(7.31,13.32)	13.32(6.69,19.02)	-2.543	<0.001

危险因素	偏回归系数	标准误	Wald值	OR值	95%CI	P值
年龄	0.058	0.016	12.576	1.059	1.026~1.094	<0.001
GCS评分
9~15分				Ref
3~8分	3.566	0.406	77.044	35.392	15.960~78.482	<0.001
白细胞计数	0.568	0.288	3.896	1.765	1.004~3.102	0.048
血小板计数	-0.022	0.008	6.979	0.979	0.963~0.994	0.008
血小板-淋巴细胞比值	0.005	0.003	4.356	1.005	1.000~1.010	0.037

危险因素	偏回归系数	标准误	Wald值	OR值	95%CI	P值
年龄	0.058	0.016	12.576	1.059	1.026~1.094	<0.001
GCS评分
9~15分				Ref
3~8分	3.566	0.406	77.044	35.392	15.960~78.482	<0.001
白细胞计数	0.568	0.288	3.896	1.765	1.004~3.102	0.048
血小板计数	-0.022	0.008	6.979	0.979	0.963~0.994	0.008
血小板-淋巴细胞比值	0.005	0.003	4.356	1.005	1.000~1.010	0.037

危险因素	曲线下面积	敏感度	特异度	截断值	95%CI	P值
年龄	0.631	57.58	63.21	62.00	0.577~0.682	<0.001
GCS评分	0.923	84.85	86.79	9.00	0.890~0.949	<0.001
白细胞计数	0.590	33.33	85.36	15.94	0.537~0.643	0.027
血小板计数	0.604	78.79	42.14	191.00	0.550~0.656	0.006
血小板-淋巴细胞比值	0.640	43.94	83.21	92.61	0.586~0.690	0.001

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