Is admission neutrophil-to-lymphocyte ratio an outcome predictor in critically ill multiple trauma patients? A retrospective single-centre cross-sectional study

Abstract

Background

Trauma is a global health concern with a high mortality rate. Research suggests a potential link between neutrophil-to-lymphocyte ratio (NLR) and mortality. This study aims to assess the prognostic value of NLR in intensive care unit (ICU)-admitted individuals with multiple trauma.

Methods

This study reviewed medical records of multiple trauma patients admitted to the ICU of Shahid Mohammadi Hospital in Bandar Abbas, Iran, from 2020 to 2021. Variables assessed included age, sex, blood pressure, Glasgow Coma Scale, Injury Severity Score, NLR, trauma details, surgical procedures, hospital and ICU length of stay, duration of mechanical ventilation, and mortality.

Results

In the study, 160 multiple trauma patients were analyzed, with an average age of 34.13 ± 14.74 years. Among them, 130 (81.3%) were male and 75 (46.9%) died. The mean NLR did not show a significant difference between survivors and non-survivors (p = 0.853). The predictive ability of NLR for mortality, as measured by the area under the receiver operating characteristic curve, was 0.530 (95% confidence interval [CI] 0.440; 0.620, p = 0.517). Patients who died had higher rates of ICU admission, mechanical ventilation requirement, longer mechanical ventilation duration, and longer hospital and ICU stays (all p < 0.001). Multivariable logistic regression analysis found that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality compared to a sinus rhythm (adjusted odds ratio = 7.961, 95% CI 1.724; 36.759, p = 0.008). No significant association was found between NLR and mortality in univariable binary logistic regression, even after adjusting for various factors (adjusted OR = 0.967, 95% CI 0.989; 1.042, p = 0.375).

Conclusions

Our findings indicate that admission NLR did not demonstrate efficacy as a prognostic indicator of mortality among patients with multiple trauma admitted to the ICU.

Keywords

Multiple trauma mortality neutrophil-to-lymphocyte ratio

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