Evaluating the role of glucose-to-lymphocyte ratio as a prognostic indicator in pediatric moderate to severe traumatic brain injury

Reza Fatahian ¹, Constana Gracia ², Seyed Reza Bagheri ³

⁰Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

European Journal of Medical Research +

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November 5, 2025

View abstract on PubMed

Summary

High glucose-to-lymphocyte ratio (GLR) indicates poor outcomes in pediatric traumatic brain injury (TBI). This easily measured biomarker can predict clinical prognosis in children with moderate to severe TBI.

Area Of Science

Pediatric critical care medicine
Neurotrauma research
Biomarker discovery

Background

Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in children globally.
Understanding TBI's clinical implications is crucial for improving pediatric treatment and rehabilitation.
This study investigates the link between glucose-to-lymphocyte ratio (GLR) and clinical outcomes in pediatric moderate to severe TBI.

Purpose Of The Study

To determine the association between GLR levels and clinical outcomes in pediatric patients with moderate to severe TBI.
To evaluate GLR as a potential predictive biomarker for TBI prognosis in children.
To identify factors influencing clinical outcomes in pediatric TBI.

Main Methods

Retrospective analysis of clinical, radiographic, and laboratory data from pediatric TBI patients (July 2017 - May 2024).
Patients managed per Advanced Trauma Life Support (ATLS) guidelines.
Outcomes assessed using the Glasgow Outcome Scale (GOS) at discharge, categorizing patients into favorable (GOS 4-5) and unfavorable (GOS 1-3) groups.

Main Results

Out of 424 pediatric TBI patients, 39.2% had a high GLR (>93.4).
Independent risk factors for poor prognosis included lower GCS, higher Rotterdam score, impaired pupillary light reflex, and elevated GLR.
GLR level was independently associated with poor prognosis (OR: 1.63; 95% CI 1.18 - 2.78; p=0.033).

Conclusions

Elevated GLR levels are a valuable indicator of poor clinical outcomes in pediatric moderate to severe TBI.
GLR is a cost-effective and easily obtainable biomarker with significant predictive value for TBI prognosis in children.
This finding supports the use of GLR in assessing the clinical outlook for pediatric TBI patients.

Keywords:

Clinical outcomes Glucose-to-lymphocyte ratio Pediatric patients Traumatic brain injury