11. CLINICAL AND PARACLINICAL CHARACTERISTICS NEUTROPHIL-TO-LYMPHOCYTE RATIO CHANGES, AND THEIR ASSOCIATION WITH TREATMENT OUTCOMES IN MULTIPLE TRAUMA PATIENTS AT MILITARY HOSPITAL 175
Main Article Content
Abstract
Objectives: To identify the clinical and paraclinical characteristics and the relationship between the change in neutrophil/lymphocyte ratio (NLR) and treatment outcomes in trauma patients treated at Military Hospital 175.
Method: A descriptive, longitudinal study on 60 trauma patients who was diagnosed according to the Berlin criteria of 2014 at Military Hospital 175 from June 2024 to May 2025. Data were collected at the following time points: T0 (admission), T1 (24 hours after admission), and T2 (48 hours after admission).
Results: The majority of patients were male (73.3%), with 86.7% aged between 20 and 60 years, and the main cause was traffic accidents (81.7%). The most common injuries were chest trauma (80%) and traumatic brain injury (61.7%), with 40% of patients sustaining injuries to two organ systems. The median duration of mechanical ventilation and hospital stay were 4 days and 10 days, respectively. The mortality rate in the study population was 28.3%. The NLR value at admission for the survival and death groups were 9.86 and 15.3, respectively. The NLR at admission has predictive value for mortality in trauma patients, with an area under the curve (AUC) of 0.774, p < 0.05, and a cut-off point of 8.32 with sensitivity Se = 100% and specificity Sp = 46%.
Conclusion: Trauma patients treated at Military Hospital 175 are primarily male, of working age, due to traffic accidents. Chest trauma and traumatic brain injury are the two most common injuries. The NLR value at admission has prognostic significance for mortality in trauma patients
Article Details
Keywords
Multiple trauma, neutrophil-to-lymphocyte ratio.
References
[2] Phùng Việt Chiến, Bùi Văn Mạnh, Đặng Văn Ba và cộng sự. Nghiên cứu giá trị tiên lượng tử vong của thang điểm ISS, GAP, MGAP ở bệnh nhân đa chấn thương. Tạp chí Y học Việt Nam, 2023, 530 (1), tr. 255-259.
[3] Imtiaz F, Shafique K, Mirza S.S et al. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. International Archives of Medicine, 2012, 5: 2. DOI: 10.1186/1755-7682-5-2.
[4] Lê Đăng Mạnh. Nghiên cứu biến đổi một số chỉ số đông máu và mối tương quan với yếu tố tiên lượng mức độ nặng ở bệnh nhân đa chấn thương. Luận văn bác sĩ nội trú, Học viện Quân y, 2021.
[5] Wafaisade A, Lefering R, Bouillon B et al. Epidemiology and risk factors of sepsis after multiple trauma: An analysis of 29,829 patients from the trauma registry of the german society for trauma surgery. Crit Care Med., 2011, 39 (4): 621-628. DOI: 10.1097/CCM.0b013e318206d3df.
[6] Cap A, Hunt B.J. The pathogenesis of traumatic coagulopathy. Anaesthesia, 2015, 70 (1): 96-101. DOI: 10.1111/anae.12914.
[7] Mazandarani P.D, Heydari K, Hatamabadi H et al. Acute Physiology and Chronic Health Evaluation (APACHE) III Score compared to Trauma-Injury Severity Score (TRISS) in Predicting Mortality of Trauma Patients. Emerg (Tehran), 2016, 4 (2): 88-91. PMCID: PMC4893757.
[8] Pape H.C, Lefering R, Butcher N et al. The definition of polytrauma revisited: An international consensus process and proposal of the new 'Berlin definition. J Trauma Acute Care Surg, 2014, 77 (5): 780-786. DOI: 10.1097/TA.0000000000000453.
[9] Lâm Võ Hùng, Trần Văn Lời, Võ Văn Đức Khôi và cộng sự. Giá trị bảng điểm chấn thương cải tiến (revised trauma score) trong tiên lượng sống còn bệnh nhân tai nạn giao thông. Kỷ yếu Hội nghị khoa học, Bệnh viện An Giang, 10/2012, tr. 164-171.
[10] Soulaiman S.E, Dopa D, Raad A.T, et al. Cohort retrospective study: The neutrophil to lymphocyte ratio as an independent predictor of outcomes at the presentation of the multi-trauma patient. Int J Emerg Med, 2020, 13 (1): 5. DOI: 10.1186/s12245-020-0266-3.