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Purpose <p>Biomarkers are used to establish the diagnosis, staging, and prognosis of diseases. The scope of this study was to assess and compare the performance and accuracy of blood glucose (BG) and neutrophil-lymphocyte ratio (NLR) as predictive biomarkers of mortality in children with traumatic brain injury (TBI).</p> Methods <p>Cross-sectional analytical study through the review of consecutive medical records of children and adolescents (&lt; 17&#xa0;years) with TBI. The results of blood samples collected in the first 24&#xa0;h after trauma were reviewed, considering BG ≥ 200&#xa0;mg/dL or 11.1&#xa0;mmol/L and NLR ≥ 11 as cutoff points. The receiver operating characteristic (ROC) curve was applied to verify and compare the performance of both biomarkers as predictors of in-hospital mortality. The odds ratio (OR), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), accuracy, and likelihood of both biomarkers were calculated.</p> Results <p>Of the 131 children included in the analyses, 13% had hyperglycemia, predominantly those with severe TBI (30% vs. 4%; <i>p</i> = 0003). NLR values ≥ 11 were identified in 21% of the sample, also predominating in children with severe TBI (54% vs. 15%; <i>p</i> = 0.01). The performance of BG and NLR was respectively 0.81 and 0.65 considering the area under the ROC curve. BG presented an accuracy of 88% and NLR of 79% as predictive biomarkers of mortality.</p> Conclusion <p>BG presented better performance and accuracy than NLR, although both biomarkers presented high NPV to identify children at lower risk of death.</p>

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Performance and accuracy of blood glucose and neutrophil-lymphocyte ratio as predictors of mortality in children and adolescents with traumatic brain injury

  • 期刊论文

  • 发表日期：

    2026年1月4日

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  • José Roberto Tude Melo,
  • Caio Vinicius de Almeida Chaves,
  • Cindy Kawano,
  • Isabela Zampirolli Leal,
  • Maria Antonia Coladeti Fernandes,
  • Stephannie Monaco Bodra,
  • Jean Gonçalves de Oliveira,
  • José Carlos Esteves Veiga

摘要

Purpose

Biomarkers are used to establish the diagnosis, staging, and prognosis of diseases. The scope of this study was to assess and compare the performance and accuracy of blood glucose (BG) and neutrophil-lymphocyte ratio (NLR) as predictive biomarkers of mortality in children with traumatic brain injury (TBI).

Methods

Cross-sectional analytical study through the review of consecutive medical records of children and adolescents (< 17 years) with TBI. The results of blood samples collected in the first 24 h after trauma were reviewed, considering BG ≥ 200 mg/dL or 11.1 mmol/L and NLR ≥ 11 as cutoff points. The receiver operating characteristic (ROC) curve was applied to verify and compare the performance of both biomarkers as predictors of in-hospital mortality. The odds ratio (OR), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), accuracy, and likelihood of both biomarkers were calculated.

Results

Of the 131 children included in the analyses, 13% had hyperglycemia, predominantly those with severe TBI (30% vs. 4%; p = 0003). NLR values ≥ 11 were identified in 21% of the sample, also predominating in children with severe TBI (54% vs. 15%; p = 0.01). The performance of BG and NLR was respectively 0.81 and 0.65 considering the area under the ROC curve. BG presented an accuracy of 88% and NLR of 79% as predictive biomarkers of mortality.

Conclusion

BG presented better performance and accuracy than NLR, although both biomarkers presented high NPV to identify children at lower risk of death.