| Objective: To investigate the function of the peripheral blood neutrophil to lymphocyte ratio (NLR) at initial admission in the early assessment of injury severity in patients with spinal cord injury (SCI). Methods: A total of 62 patients with SCI admitted to the Emergency Department of Southwest Hospital of Army Medical University then transferred to the Department of Rehabilitation Medicine from June 2010 to January 2021 were analyzed retrospectively. According to the ASIA Impairment Scale, the included patients were dichotomized into either the complete motor function injury group (ASIA Impairment Scale A and B, n=35) and the incomplete motor function injury group (ASIA Impairment Scale C and D, n=27). The clinical data and laboratory test data of the two groups were collected, and NLR was calculated according to the neutrophil count and lymphocyte count at admission. The univariate analysis was used to compare the data differences between the two groups, the multivariate Logistic regression was used to analyze the possible risk factors of complete motor function injury, and the evaluation ability of each index was evaluated by the area under the receiver operating characteristic (ROC) curve. Results: The NLR at initial admission in the complete motor function injury group was significantly higher than that in the incomplete mo-tor function injury group (P<0.05), and the lymphocyte count was significantly lower in the complete motor function injury group than that in the incomplete motor function injury group (P<0.01). The results of multivariate Logistic regression analysis showed that the increase of lymphocyte count was an independent protec-tive factor for complete motor function injury after adjusting for confounding factors (OR=0.211, 95%CI: 0.051-0.878, P<0.05). The area under the ROC curve of NLR was 0.726 (95%CI: 0. 598-0.854, P<0.05). When the cut-off value was 9.711, the maximum Youden index was 0.398, its sensitivity was 65.71% and specificity was 74.07%. The area under the ROC curve of lymphocyte count was 0.740 (95%CI: 0.610-0.870, P<0.05). When the cut-off value was 1.220, the maximum Youden index was 0.461, the sensitivity was 94.29% and specificity was 51.85%. The area under the ROC curve of the combination of NLR and lymphocyte count was 0.751 (95%CI: 0.62500.878, P<0.05). Conclusion: As simple, cheap and easily available, the NLR at initial admission may have a certain value in evaluating the severity of early SCI. |
