The Role Of Inflammatory Biomarkers NLR And PLR In Predicting Functional Outcomes Following Traumatic Brain Injury

Abstract

Background: Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality among trauma patients in developing countries. The post-traumatic inflammatory response plays a critical role in worsening patient outcomes. Routine hematological examinations such as complete blood count can provide information of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Both markers have reported as simple and relatively inexpensive inflammatory markers. Identification of these biomarkers is expected to assist in predicting outcomes, particularly through assessment with the Glasgow Outcome Scale (GOS). This study was aimed to analyze the correlation between NLR and PLR with GOS in TBI patients.

Method: This research was a prospective observational analytic study using consecutive sampling technique at Dr. Soetomo General Hospital Surabaya between March and June 2025. NLR and PLR values were obtained within 24 hours after trauma. Clinical outcome (GOS) was assessed on day 14. Data analysis was performed using SPSS, with p < 0,05 considered statistically significant.

Results: Total of 44 patients were included in this study, with the majority of patients being male (63,6%) and median age of 32,5 years. The most common clinical outcome was GOS 5 (good recovery, 54,5%), while rate mortality was 27,3%. Median value of NLR was 8,35 and mean value of PLR was 170,45. Statistical analysis revealed no significant correlation between NLR and GOS (p = 0,338). In contrast, PLR showed a moderate positive correlation with GOS (r = 0,527, p < 0,001), with cut-off value of 101,24.

Conclusion: NLR was not associated with GOS in TBI patients, whereas PLR showed a significant correlation with better clinical outcomes. PLR may serve as a simple biomarker to predict prognosis in TBI patients.