Neurocritical Care

, Volume 30, Issue 2, pp 334–339 | Cite as

Peak Neutrophil-to-Lymphocyte Ratio Correlates with Clinical Outcomes in Patients with Severe Traumatic Brain Injury

  • Jigang Chen
  • Xiaolin Qu
  • Zhenxing Li
  • Danfeng ZhangEmail author
  • Lijun HouEmail author
Original Article



Studies suggested that the neutrophil-to-lymphocyte ratio (NLR) was associated with unfavorable outcomes in different diseases such as intracerebral hemorrhage, cardiovascular problem, cancer, and severe traumatic brain injury (sTBI). We aimed to evaluate the relationship between peak NLR and 1-year outcomes in patients with sTBI.


We retrospectively reviewed the clinical data of patients with sTBI who were treated in our department between January 2013 and January 2017. NLRs between day 1 and day 12 after admission as well as other related indicators were collected. The relationship between peak NLR and 1-year outcomes was analyzed. Factors associated with larger peak NLR were also explored.


A total of 316 patients were included, and 81.3% (257/316) experienced unfavorable outcomes. Peak NLR was identified as an independent predictor for unfavorable outcomes after sTBI in multivariable logistic regression analysis (odds ratio, 1.086; 95% confidence interval, 1.037–1.137; P < 0.001). Its predictive value was confirmed by receiver operating characteristic analysis (area under curve = 0.775; P < 0.001). The day 1 NLR as well as admission Glasgow Coma Scale score was independently correlated with increased peak NLR.


Peak NLR was associated with the clinical prognosis after sTBI and was a promising predictor for 1-year outcomes.


Neutrophil-to-lymphocyte ratio Peak value Severe traumatic brain injury Clinical outcomes 



We’d like to express our sincere gratitude to Chengguang Huang, Minkun Yu, Kehua Sun, and Rulin Bai in Changzheng Hospital for their work in providing the clinical data.

Author Contribution

JC and XQ conducted the study design, data collection, and data analysis. ZL and DZ prepared the manuscript. LH reviewed and finalized the manuscript.

Source of Support

This study was funded by the National Nature Science Foundation of China (Grant No. 81671206).

Compliance with Ethical Standards

Conflict of interest

Lijun Hou received grants from National Nature Science Foundation of China. The other authors declared they had no conflicts of interest.

Ethical Approval

All procedures performed in the studies were in accordance with the ethical standards of the Changzheng Hospital and its later amendments or comparable ethical standards. For this type of study, formal consent was not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Changzheng HospitalSecond Military Medical UniversityShanghaiChina

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