Differential impact of neutrophil-to-lymphocyte ratio and time-weighted NLR on mortality and survival in critically ill children: insights from a retrospective study

The study confirms NLR, particularly in its time-weighted form, as a robust prognostic indicator for critically ill children. Elevated time-weighted NLR levels are associated with increased in-hospital mortality and shorter ICU stays, highlighting its potential for risk stratification and guiding clinical decisions in PICU. The dynamic nature of the time-weighted NLR provides a more accurate reflection of the patient's inflammatory burden over time. However, the retrospective and single-center design of the study limits the generalizability of the results. Future research should address these limitations and explore the integration of NLR with other clinical and laboratory parameters to enhance prognostic accuracy in pediatric critical care settings.