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Neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic spinal cord injury

Spinal Cord volume 62, pages 59–64 (2024)Cite this article

Subjects

Abstract

Study design

A retrospective study.

Objective

This study examined the value of neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic SCI.

Setting

The First People’s Hospital of Neijiang, China.

Methods

This was a single-center, retrospective, cohort study of patients treated within 12 h of acute SCI between January 2018 and October 2022. Ninety-four SCI patients were selected as the Observation group, including 26 with complete injury (AIS grade A) and 68 with incomplete injury (AIS grade B–D), while 94 patients with simple spinal fracture were randomly selected as the Control group. Eighty-one observation group patients underwent surgical treatment, of which 33 had a higher AIS grade (Good prognosis subgroup) and 48 a lower or equal grade post-surgery (Poor prognosis subgroup). Univariate and multivariate analyses were performed to assess predictors of early diagnosis, severity, and 6-month outcome.

Results

Initial white blood cell count, neutrophil count, monocyte count, and NLR were higher in the Observation group than the Control group, while lymphocyte count was lower in the Observation group. Multivariate logistic regression analysis identified NLR as an independent predictor of early diagnosis. Spinal canal encroachment ≥50%, neutrophil count, and NLR were higher in the complete injury subgroup, and spinal canal encroachment ≥50% was an independent predictor of complete injury, while NLR was not. The NLR was higher in the poor prognosis subgroup and was an independent risk factor.

Conclusions

Peripheral blood NLR is useful for early diagnosis of acute SCI and is predictive of clinical outcome.

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Fig. 1: ROC of the NLR for early diagnosis of acute traumatic SCI.
Fig. 2: ROC of the NLR for the assessment of acute traumatic SCI severity.
Fig. 3: ROC of the prognostic value of NLR for acute traumatic SCI.

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Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, The First people’s Hospital of Neijiang, Neijiang, China

    Xiao Chen, Yong-qiang Zhou, Chang Chen & Yuan Cao

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  1. Xiao Chen
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Contributions

XC and Y-QZ contributed to the study’s conception and design. Material preparation and data collection were performed by XC, Y-QZ, CC and YC. The first draft of the manuscript was written by XC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Correspondence to Xiao Chen.

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Chen, X., Zhou, Yq., Chen, C. et al. Neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic spinal cord injury. Spinal Cord 62, 59–64 (2024). https://doi.org/10.1038/s41393-023-00949-4

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