Siempis Timoleon, Georgalis Pavlos A, Lianos Georgios, Kafritsas Georgios, Metaxas Dimitrios, Alexiou Eleutherios-Spyridon, Zika Jiolanda, Sotiropoulos Athanasios, Alexiou George A, Voulgaris Spyridon
Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece.
Department of Surgery, University Hospital of Ioannina, 45500 Ioannina, Greece.
J Integr Neurosci. 2023 Jul 7;22(4):91. doi: 10.31083/j.jin2204091.
Paediatric Traumatic Brain Injury (TBI) has received less research attention compared to TBI in adults, despite its potential morbidity in all ages. Our aim was to determine whether neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and glucose levels at admission can reliably predict the need for imaging in children presenting with mild TBI.
We retrospectively reviewed the clinical records of paediatric patients who presented in the emergency department with mild TBI within a 5 year period and had undergone computed tomography (CT) scan of the head.
Overall, 43 eligible patients were included in the study, with falls being the most commonly reported cause of injury. Twenty-three children had positive CT findings. Patients with abnormal CT findings were found to have higher NLR ratios compated with patients with normal CT, with the mean NLR on admission being 5.2 ± 3.8. Children with abnormal CT findings had lower PLR levels and higher glucose levels at presentation compared to children with normal CT, however the differences were not statistically significant. Using the receiver operating characteristic (ROC) curve, we found that a NLR cut off value of 6.1 yielded a sensitivity of 54.2% and a specificity of 89.5% for the prediction of abnormal CT findings.
The findings of this study suggest that NLR may have a role in CT decision-making in the emergency department for mild TBI in paediatric patients.
尽管小儿创伤性脑损伤（TBI）在各年龄段都有潜在的发病率，但与成人TBI相比，其受到的研究关注较少。我们的目的是确定入院时的中性粒细胞与淋巴细胞比率（NLR）、血小板与淋巴细胞比率（PLR）和血糖水平是否能可靠地预测轻度TBI患儿的成像需求。
我们回顾性分析了5年内因轻度TBI到急诊科就诊并接受头部计算机断层扫描（CT）的儿科患者的临床记录。
总体而言，43名符合条件的患者被纳入研究，跌倒为最常见的受伤原因。23名儿童CT检查结果呈阳性。与CT检查结果正常的患者相比，CT检查结果异常的患者NLR比率更高，入院时的平均NLR为5.2±3.8。与CT检查结果正常的儿童相比，CT检查结果异常的儿童就诊时PLR水平较低，血糖水平较高，但差异无统计学意义。使用受试者工作特征（ROC）曲线，我们发现NLR临界值为6.1时，预测CT检查结果异常的灵敏度为54.2%，特异度为89.5%。
本研究结果表明，NLR可能在急诊科对小儿轻度TBI的CT决策中发挥作用。
