Importance of the neutrophil‑to‑lymphocyte ratio as a prognostic factor in patients with spleen trauma: A single center experience

Vunvulea,Vlad; Suciu,Bogdan Andrei; Cocuz,Iuliu Gabriel; Bacalbașa,Nicolae; Molnar,Călin; Ghiga,Dana Valentina; Hălmaciu,Ioana

doi:10.3892/br.2022.1563

Importance of the neutrophil‑to‑lymphocyte ratio as a prognostic factor in patients with spleen trauma: A single center experience

Authors:
- Vlad Vunvulea
- Bogdan Andrei Suciu
- Iuliu Gabriel Cocuz
- Nicolae Bacalbașa
- Călin Molnar
- Dana Valentina Ghiga
- Ioana Hălmaciu
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Affiliations: Medicine and Pharmacy Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540142 Târgu Mureş, Romania, Anatomy Department, University of Medicine and Pharmacy of Târgu Mureş, 540139 Târgu Mureş, Romania, Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, George Emil Palade University of Medicine, Pharmacy Science and Technology, 540142 Târgu Mureş, Romania, Department of Methodology of Scientific Research, George Emil Palade University of Medicine, Pharmacy Science and Technology, 540142 Târgu Mureş, Romania
Published online on: August 17, 2022 https://doi.org/10.3892/br.2022.1563
Article Number: 80
Copyright: © Vunvulea et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Abdominal trauma is a common diagnosis for patients admitted to the emergency room. Evaluation of the severity of such patients can sometimes be difficult due to rapid hemodynamic changes caused by the activation of inflammatory and anti‑inflammatory regulatory mechanisms. To evaluate the prognosis of trauma patients, it is crucial to identify these changes and adapt various treatment strategies. Using the records of the Mures County Emergency Clinical Hospital, 126 patients were included in the present study with traumatic splenic injury admitted over 6 years. Blood parameters such as the neutrophil, lymphocyte, and platelet counts, the neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio (PLR) were determined, and the association between these and the severity of the traumatic injury [quantified as the injury severity score (ISS)] was calculated. We used linear and multiple regression analyses to identify and quantify the relationships. We found statistically significant associations between the ISS and the NLR (P=0.002), with an AUC of 0.816 and a cut‑off value of NLR=6.075 (sensitivity=76.7%, specificity=74.3%), and between the ISS and hemoglobin (P<0.0001), hematocrit (P<0.0001), neutrophil count (P<0.0001), lymphocyte count (P=0.0224), and platelet count (P=0.0163). No association was found between the PLR and the severity of trauma. An elevated NLR at admission in trauma patients had significant predictive power for the severity of trauma. Patients with an NLR greater than the cut‑off value of 6.075 were more likely to have suffered serious injuries and undergone deterioration.

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