Vunvulea Vlad, Andrei Suciu Bogdan, Gabriel Cocuz Iuliu, Bacalbașa Nicolae, Molnar Călin, Valentina Ghiga Dana, Hălmaciu Ioana
Medicine and Pharmacy Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
Anatomy Department, University of Medicine and Pharmacy of Târgu Mureș, 540139 Târgu Mureș, Romania.
Biomed Rep. 2022 Aug 17;17(4):80. doi: 10.3892/br.2022.1563. eCollection 2022 Oct.
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.
腹部创伤是急诊室收治患者的常见诊断。由于炎症和抗炎调节机制激活导致的快速血流动力学变化，有时难以评估此类患者的严重程度。为评估创伤患者的预后，识别这些变化并调整各种治疗策略至关重要。利用穆列什县急诊临床医院的记录，本研究纳入了6年间收治的126例创伤性脾损伤患者。测定了中性粒细胞、淋巴细胞和血小板计数、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLR）等血液参数，并计算了这些参数与创伤严重程度[以损伤严重程度评分（ISS）量化]之间的关联。我们使用线性和多元回归分析来识别和量化这些关系。我们发现ISS与NLR之间存在统计学显著关联（P = 0.002），AUC为0.816，NLR的临界值为6.075（敏感性 = 76.7%，特异性 = 74.3%），ISS与血红蛋白（P < 0.0001）、血细胞比容（P < 0.0001）、中性粒细胞计数（P < 0.0001）、淋巴细胞计数（P = 0.0224）和血小板计数（P = 0.0163）之间也存在关联。未发现PLR与创伤严重程度之间存在关联。创伤患者入院时NLR升高对创伤严重程度具有显著预测能力。NLR大于临界值6.075的患者更有可能遭受重伤并出现病情恶化。
