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| The value of blood uric acid/platelet count ratio for severity evaluation and prognosis prediction of traumatic brain injury |
| Chen Du, Xu Feng |
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Abstract Objective To investigate the value of blood uric acid/platelet count ratio for the severity evaluation and prognosis prediction of traumatic brain injury. Methods A total of 330 patients with traumatic brain injury (GCS 3~14) admitted to the First Affiliated Hospital of Soochow University between Nov. 2010 and Oct. 2012 were enrolled. Patients were divided into a survival group (GOS 2~5) and a death group (GOS 1). The level of blood uric acid (μmol/L) and platelet count(×109/L)were determined from the vein blood in the next morning after admission, and natural logarithm of the ratio between them was defined as an UP index. Clinical data were retrospectively analyzed by logistic regression model, Spearman correlation, and ROC curve. Results There were significantly differences in blood uric acid［329 (254, 435) vs 238 (117, 292), P=0.000］, platelet count (78.4±56.5 vs.151.5±75.4, P=0.000) and UP index (1.679±0.987 vs.0.529±0.664, P=0.000) between two groups. Spearman correlation analysis indicated that the UP index was significantly correlated with GOS (r=-0.5703, P=0.000), GCS (r=-0.4959, P=0.000) and ISS (r=0.4837, P=0.000). Furthermore, it was determined as an independent predictor for death of traumatic brain injury by multiple Logistic regression model. Adjusted by three important predictors (Age, GCS and Pupil reaction), the OR of UP index was 3.199 (95%CI 1.940~ 5.275, P=0.000). There was no statistically difference (P=0.266) in the area under the ROC curve for mortality prediction between UP index (AUC=0.853, 95%CI 0.810~0.889) and GCS (AUC=0.885, 95%CI 0.846-0.917). The optimal cut-off value of UP index determined by the Youden index was 0.955 (sensitivity 9.52%, specificity 80.97%, correctly classified 80.61%). Conclusion The blood uric acid/platelet count ratio at admission is very important for traumatic brain injury. Natural logarithm of the ratio is significantly correlated with severity and could be used as a novel independent predictor for mortality.
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Received: 06 January 2017
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