A comparative analysis of Rotterdam score and neutrophil-to-lymphocyte ratio in predicting outcomes for patients with moderate to severe traumatic brain injury

This study aimed to evaluate the role of NLR in predicting outcomes for patients with moderate to severe TBI. A retrospective analysis was conducted from April 2020 to April 2022, including patients aged 16 and older with Glasgow Coma Scale (GCS) scores of 8 or below admitted to Shahid Beheshti Hospital, Kashan. Data on NLR and other clinical markers were collected. Rotterdam scores were calculated using CT scan findings. Patients were followed up for six months post-trauma or until death, and associations between NLR and clinical outcomes were analyzed, with significance set at P < 0.05. Among 195 patients, 130 (66%) had unfavorable outcomes at six months. Admission NLR was significantly higher in patients with unfavorable outcomes compared to those with favorable outcomes (P < 0.001). Receiver operating characteristic analysis indicated that NLR had a sensitivity of 82% and specificity of 91% at a threshold of 5.2 for predicting unfavorable outcomes. Elevated admission NLR in patients with severe TBI was linked to unfavorable six-month functional outcomes and mortality. NLR may serve as a readily accessible clinical marker for prognostication in moderate to severe TBI.