Li Zhiqi, Wu Xing, Wu Xuehai, Yu Jian, Yuan Qiang, Du Zhuoying, Hu Jin
a Department of Neurosurgery , Huashan Hospital, Fudan University , Shanghai , China.
Brain Inj. 2018;32(4):515-522. doi: 10.1080/02699052.2018.1429023. Epub 2018 Jan 22.
The aim of this study was to assess the prognostic value of admission immune cell levels in the peripheral blood in determining outcomes in patients with TBI.
We studied 141 adult patients with mild-to-severe TBI (Glasgow Coma Scale (GCS) 3-15). Patient outcome was assessed using the Extended Glasgow Outcome Scale (GOSE) at 6 months post-injury. The area under the curve (AUC) was used to evaluate the predictive ability of immune cell levels. Uni- and multivariate analyses were performed to assess the independent predictors of 6-month outcome.
We found that admission monocyte count was not only a better predictor (AUC = 0.778; 95% confidence interval (CI), 0.679-0.858) of favourable outcomes (GOSE 5-8) at 6 months post-injury than were admission haemoglobin (AUC = 0.629; 95% CI, 0.522-0.728) and blood glucose (AUC = 0.616; 95% CI, 0.508-0.716) levels for patients with moderate-to-severe TBI (GCS ≤ 12), but also an independent predictor of 6-month outcome (adjusted odds ratio, 1.35; 95% CI, 1.10-1.65; p = 0.004).
The present study suggests that an increase in admission monocyte count is correlated with a favourable 6-month outcome in patients with moderate-to-severe TBI.
本研究旨在评估外周血中入院时免疫细胞水平对创伤性脑损伤（TBI）患者预后的预测价值。
我们研究了141例成人轻至重度TBI患者（格拉斯哥昏迷量表（GCS）评分3 - 15分）。在受伤后6个月，使用扩展格拉斯哥预后量表（GOSE）评估患者预后。曲线下面积（AUC）用于评估免疫细胞水平的预测能力。进行单因素和多因素分析以评估6个月预后的独立预测因素。
我们发现，对于中至重度TBI患者（GCS≤12），入院时单核细胞计数不仅比入院时血红蛋白（AUC = 0.629；95%置信区间（CI），0.522 - 0.728）和血糖（AUC = 0.616；95%CI，0.508 - 0.716）水平更能预测受伤后6个月的良好预后（GOSE 5 - 8）（AUC = 0.778；95%CI，0.679 - 0.858），而且是6个月预后的独立预测因素（调整优势比，1.35；95%CI，1.10 - 1.65；p = 0.004）。
本研究表明，中至重度TBI患者入院时单核细胞计数增加与6个月良好预后相关。
