The association between the dynamics of red cell distribution width to lymphocyte ratio and clinical outcomes in patients with traumatic brain injury.

Background: Traumatic brain injury (TBI) is a major cause of morbidity and mortality, particularly among young individuals. This study investigates the correlation between the dynamic of Red Cell Distribution Width to Lymphocyte Ratio (RDWLR) and clinical outcomes in patients with moderate to severe TBI.

Methods: A retrospective analysis was conducted on 405 consecutive patients with moderate to severe TBI admitted between July 2018 and July 2023. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS), categorized into favorable (GOS 4,5) and unfavorable outcomes (GOS 1,2,3). Data on demographics, clinical presentation, radiological findings, and laboratory tests were collected. Binary logistic regression analyzed the independent associations between variables, including changes in RDWLR over four days.

Results: Among the 405 patients, 53.1% were male, with an average age of 33.21 years. ROC curve analysis identified a delta RDWLR threshold of 0.001. Of the patients, 67.1% had low delta RDWLR, while 33.8% had high delta RDWLR. Multivariate analysis showed that Glasgow Coma Scale (GCS) (OR 3.22;  < 0.001), light reflex (OR 1.87;  = 0.025), Rotterdam CT score (OR 2.33; = 0.025), and change in RDWLR (OR 1.68;  = 0.031) were significantly associated with poor clinical outcomes.

Conclusions: These findings suggest that delta RDWLR has potential as as a prognostic indicator of poor clinical outcomes in patients with moderate to severe traumatic brain injury (TBI), providing a cost-effective biomarker for clinical prognosis. However, further validation through prospective multicenter studies is needed.