International Journal of Advances in Medicine | January 2022 | Vol 9 | Issue 1 Page 10 International Journal of Advances in Medicine Ghosh T et al. Int J Adv Med. 2022 Jan;9(1):10-14 http://www.ijmedicine.com pISSN2349-3925 | eISSN2349-3933 Original Research Article Correlation between neutrophil lymphocyte count ratio and outcomes of severe traumatic head injury Tamajyoti Ghosh*, Subir Dey INTRODUCTION Traumatic brain injury (TBI) is a critical public health and socioeconomic problem throughout the world. 1-3 TBI is a major health and socioeconomic problem that affects all societies around the world. More than 10 million people worldwide suffer TBI serious enough to result in death or hospitalization each year NLCR is a marker of inflammatory response of the body. 4 It can thus be utilised as a clinical marker in judging the severity of outcome following traumatic brain injury. In India reported incidence of TBI is 55-120 per 100000 population. 5,6 A study from tertiary care institute has reported that the occurrence of TBI is approximately 42.5% in rural and 57.5% in urban area. 7 According to WHO data, by the year 2020, head trauma will be third largest killer in the developing world. In India studies by traffic police have shown that on an average one person dies every six min and 70% of these attributed to head and spinal trauma. 8 Road traffic accidents account for 45- 60 per cent of traumatic brain injuries in different parts of India. 9 While primary brain injury is irreversible, secondary damage-consequent to neuronal dysfunction related to trauma induced oxidative stress, ischemia, ABSTRACT Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer. Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve. Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 hr) of > 9.6 (AUC=0.931) with a p value of <0.001 with sensitivity of 100% and specificity of 79.27% and peak NLCR (48 hrs) of >12.4 (AUC= 0.973) with a p value of <0.001 with sensitivity of 100% and specificity of 89.02% were associated with unfavourable outcome. Conclusions: High NLCR and initial poor GCS are independent unfavourable prognostic factors in 1 month GOS following severe traumatic head injury. Keywords: Head Injury, Neutrophil Lymphocyte count ratio, Glasgow outcome score, Glasgow coma scale Department of Neurosurgery, Armed Forces, Medical College, Pune, Maharashtra, India Received: 30 September 2021 Revised: 17 November 2021 Accepted: 18 November 2021 *Correspondence: Dr. Tamajyoti Ghosh, E-mail: tamajyoti@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-3933.ijam20214873