Relationship between neutrophil/lymphocyte ratio and lactate level and trauma severity and prognosis in trauma patients / 医学研究生学报

ABSTRACT

ObjectiveThe pathophysiological changes caused by trauma are complex, and there is still a lack of effective markers for injury monitoring and prognosis judgment. This paper aims to investigate the relationship between neutrophil/lymphocyte ratio (NLR) and lactate level and trauma severity and prognosis in trauma patients.MethodsThe data of 169 trauma patients who met the inclusion criteria in the Department of Emergency Medicine, General Hospital of the Eastern Theater Command from January to December 2017 were retrospectively analyzed. Their gender, age, cause of injury, injury severity score (ISS), acute physiology and chronic health evaluation II (APACHE II), Glasgow coma index (GCS), NLR and lactate levels within 24 hours after the injury and other laboratory results were recorded. According to the ISS score, the patients were divided into mild injury group (ISS<16, n=78), severe injury group (16≤ISS<25, n=53), and critical injury group (ISS≥25, n=38); According to the 28-day outcomes, they were divided into death group (n=22) and survival group (n=147). The correlation between NLR and lactate levels and ISS score was analyzed, and the prognostic value was analyzed by receiver operating characteristic (ROC) curve.ResultsNLR was positively correlated with ISS (r=0.34, P<0.001), and there were significant differences among three trauma groups (P<0.001). Lactate was positively correlated with ISS (r=0.28, P=0.002) too, and significant differences were shown among three trauma groups (P=0.003). The area under the ROC curve of NLR and lactate for predicting 28-day death in trauma patients was 0.785 and 0.686, respectively.ConclusionNLR and lactate are positively correlated with trauma severity and they might play an important part in the early prognosis evaluation of trauma patients.