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Blood Biomarkers for Prediction of Positive CT Findings in Mild Traumatic Brain Injury in Paediatric Population
Timoleon Siempis1, Pavlos A Georgalis1, Georgios Lianos2
1Department of Neurosurgery, University Hospital of Ioannina, 45500 Ioannina, Greece.
Insights
Neutrophil to lymphocyte ratio (NLR) may help predict the need for imaging in children with mild traumatic brain injury (TBI). Higher NLR levels were associated with abnormal CT scan findings in paediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Neurotrauma Research
- Biomarker Discovery
Background:
- Pediatric Traumatic Brain Injury (TBI) research is less extensive than adult TBI.
- Morbidity associated with TBI affects all age groups.
- Predictive markers for imaging in mild pediatric TBI are needed.
Purpose of the Study:
- To evaluate if neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and glucose levels predict imaging needs in mild pediatric TBI.
- To assess the utility of NLR, PLR, and glucose in guiding computed tomography (CT) decisions for pediatric mild TBI.
Main Methods:
- Retrospective review of pediatric patients with mild TBI presenting to the emergency department.
- Analysis of clinical records for patients who underwent head CT scans within a 5-year period.
- Comparison of NLR, PLR, and glucose levels between patients with normal and abnormal CT findings.
Main Results:
- 43 pediatric patients were included; 23 had positive CT findings.
- Higher mean NLR (5.2 ± 3.8) was observed in patients with abnormal CT findings.
- A NLR cutoff of 6.1 demonstrated 54.2% sensitivity and 89.5% specificity for predicting abnormal CT findings.
Conclusions:
- Neutrophil to lymphocyte ratio (NLR) shows potential as a biomarker in CT decision-making for pediatric mild TBI.
- NLR may aid emergency department clinicians in determining the necessity of imaging for mild TBI in children.
- Further research is warranted to validate NLR's role in managing pediatric TBI.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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