Ilyas Muhana Fawwazy, Lado Aldebaran, Budiono Enrico Ananda, Suryaputra Gregorius Prama, Ramadhana Geizar Arsika, Novika Revi Gama Hatta
Department of Neurology, Faculty of Medicine, Dr. Moewardi General Hospital, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
Faculty of Medicine, Dr. Moewardi General Hospital, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
Surg Neurol Int. 2024 Jun 21;15:205. doi: 10.25259/SNI_878_2023. eCollection 2024.
The platelet-to-lymphocyte ratio (PLR) has emerged as a prognostic predictive marker in various diseases, but its role in traumatic brain injury (TBI) has not been fully elucidated. This study aims to evaluate the role of PLR as a prognostic predictive marker in adults with TBI.
This systematic review was conducted according to the Preferred Reporting Items in the Systematic Review and Meta-analysis Guidelines 2020. A comprehensive search was performed using PubMed, Google Scholar, Scopus, Crossref, OpenAlex, Semantic Scholar, Library of Congress, and Jisc Library Hub Discover database to identify relevant studies published up to February 2023. Both prospective and retrospective observational studies written in English or Indonesian were included in the study. No restrictions were placed on the year and country of publication and duration of follow-up. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), and the risk of bias was estimated using the Cochrane Risk of Bias Assessment Tool for Nonrandomized Research (Ro-BANS) tool. A narrative synthesis was also conducted to summarize the findings.
We retrieved 1644 references using the search strategy, and 1623 references were excluded based on screening the title and abstract. The full text was retrieved for 20 articles and subjected to the eligibility criteria, of which 16 were excluded from the study. Four papers with a total of 1.467 sample sizes were included in the review. The median of NOS for study quality was 8-9, with the risk of selection bias using the Ro-BANS tool being low in all studies except for the blinding outcome assessments, which are all unclear. The study finding suggests that the PLR has the potential as an independent prognostic predictive marker in adult patients with TBI. In three studies, a high level of admission PLR may independently predict an increasing mortality risk in 30 days and adverse outcomes measured by the Glasgow outcome scale in 6 months following TBI. However, one study shows that PLR may have limited value as a predictor of mortality or favorable neurological outcomes compared to other hematological parameters. Further studies were needed to establish the clinical utility of PLR and fill the present gaps.
This systematic review provides evidence supporting the utilization of PLR as a prognostic predictive marker in adult patients with TBI. The PLR can mainly be utilized, especially in rural practice, as PLR is a simple, low-cost, and routinely performed hematological examination.
血小板与淋巴细胞比值（PLR）已成为多种疾病的预后预测标志物，但其在创伤性脑损伤（TBI）中的作用尚未完全阐明。本研究旨在评估PLR作为成人TBI预后预测标志物的作用。
本系统评价按照《系统评价和Meta分析报告规范2020》进行。使用PubMed、谷歌学术、Scopus、Crossref、OpenAlex、语义学者、美国国会图书馆和Jisc图书馆中心发现数据库进行全面检索，以识别截至2023年2月发表的相关研究。纳入用英文或印尼文撰写的前瞻性和回顾性观察性研究。对发表年份、国家和随访时间没有限制。使用纽卡斯尔-渥太华量表（NOS）评估研究质量，使用Cochrane非随机研究偏倚风险评估工具（Ro-BANS）评估偏倚风险。还进行了叙述性综合分析以总结研究结果。
我们使用检索策略检索到1644篇参考文献，根据标题和摘要筛选排除1623篇参考文献。检索到20篇文章的全文并进行纳入标准筛选，其中16篇被排除在研究之外。纳入综述的4篇论文共有1467个样本量。研究质量的NOS中位数为8 - 9，除盲法结局评估均不明确外，所有研究使用Ro-BANS工具的选择偏倚风险较低。研究结果表明，PLR有可能作为成人TBI患者的独立预后预测标志物。在三项研究中，入院时PLR水平较高可能独立预测TBI后30天内死亡风险增加以及6个月时用格拉斯哥预后量表测量的不良结局。然而，一项研究表明，与其他血液学参数相比，PLR作为死亡率或良好神经学结局预测指标的价值可能有限。需要进一步研究以确立PLR的临床实用性并填补当前空白。
本系统评价提供了支持将PLR用作成人TBI患者预后预测标志物的证据。PLR主要可用于，特别是在农村地区，因为PLR是一项简单、低成本且常规进行的血液学检查。
