Affiliation:
1. Department of Emergency Medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2. Clinical Research Development Unit, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
3. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4. Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract
Background Trauma is a global health concern with a high mortality rate. Research suggests a potential link between neutrophil-to-lymphocyte ratio (NLR) and mortality. This study aims to assess the prognostic value of NLR in intensive care unit (ICU)-admitted individuals with multiple trauma. Methods This study reviewed medical records of multiple trauma patients admitted to the ICU of Shahid Mohammadi Hospital in Bandar Abbas, Iran, from 2020 to 2021. Variables assessed included age, sex, blood pressure, Glasgow Coma Scale, Injury Severity Score, NLR, trauma details, surgical procedures, hospital and ICU length of stay, duration of mechanical ventilation, and mortality. Results In the study, 160 multiple trauma patients were analyzed, with an average age of 34.13 ± 14.74 years. Among them, 130 (81.3%) were male and 75 (46.9%) died. The mean NLR did not show a significant difference between survivors and non-survivors ( p = 0.853). The predictive ability of NLR for mortality, as measured by the area under the receiver operating characteristic curve, was 0.530 (95% confidence interval [CI] 0.440; 0.620, p = 0.517). Patients who died had higher rates of ICU admission, mechanical ventilation requirement, longer mechanical ventilation duration, and longer hospital and ICU stays (all p < 0.001). Multivariable logistic regression analysis found that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality compared to a sinus rhythm (adjusted odds ratio = 7.961, 95% CI 1.724; 36.759, p = 0.008). No significant association was found between NLR and mortality in univariable binary logistic regression, even after adjusting for various factors (adjusted OR = 0.967, 95% CI 0.989; 1.042, p = 0.375). Conclusions Our findings indicate that admission NLR did not demonstrate efficacy as a prognostic indicator of mortality among patients with multiple trauma admitted to the ICU.