ArticleEuropean journal of medical research2025
Evaluating the role of glucose-to-lymphocyte ratio as a prognostic indicator in pediatric moderate to severe traumatic brain injury.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTraumatic brain injury (TBI) poses a significant challenge within pediatric healthcare, being one of the leading causes of illness and death among children worldwide. Comprehending the clinical implications of pediatric TBI is essential for healthcare providers aiming to improve treatment methodologies and rehabilitation strategies. This study seeks to investigate the relationship between glucose-to-lymphocyte ratio (GLR) levels and clinical outcomes in pediatric patients who have experienced moderate to severe TBI.
methodsIn this investigation, we conducted a retrospective analysis of clinical, radiographic, and laboratory data for all pediatric patients diagnosed with moderate to severe traumatic brain injury (TBI) treated at our institution from July 2017 to May 2024. All patients were managed according to the Advanced Trauma Life Support (ATLS) guidelines specifically designed for critically injured individuals with head trauma. Clinical outcomes were assessed at the time of hospital discharge using the Glasgow Outcome Scale (GOS). Based on these results, patients were categorized into two distinct groups: those who achieved favorable outcomes (GOS scores of 4 and 5) and those with unfavorable outcomes (GOS scores of 1, 2, and 3). We compared various factors that could potentially influence clinical outcomes in pediatric TBI patients, including GLR levels, between these two groups.
resultsAmong the 424 pediatric patients with moderate to severe traumatic brain injury (TBI) included in this analysis, 166 patients (39.2%) were classified into the high glucose-lymphocyte ratio (GLR) group, defined as those with a GLR exceeding 93.4. In contrast, 258 patients (60.8%) fell into the low GLR category, with a ratio at or below 93.4. The mean GLR across the cohort was noted to be 98.2 ± 29.73. The results of the binary logistic regression analyses identified several independent risk factors for poor prognosis: GCS (OR: 3.41; 95% CI 1.67 - 4.83; p < 0.001), Rotterdam score (OR: 2.55; 95% CI 1.60 - 4.21; p = 0.015), pupillary light reflex (OR: 1.91; 95% CI 1.23 - 2.98; p = 0.027), and GLR level (OR: 1.63; 95% CI 1.18 - 2.78; p = 0.033).
conclusionThe results of this study indicate that GLR levels could act as a valuable indicator of poor clinical outcomes for pediatric patients with moderate to severe TBI. This easily obtainable and cost-effective biomarker may provide significant predictive value for assessing the clinical prognosis of these patients.
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