Admission circulating monocytes level is an independent predictor of outcome in traumatic brain injury.

OBJECTIVE

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.

METHOD

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.

RESULTS

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).

CONCLUSIONS

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.