Admission blood glucose and neutrophil-to-lymphocyte ratio for differentiating CT-positive from CT-negative mild traumatic brain injury

This study aimed to assess the diagnostic utility of routine laboratory biomarkers in adults with mTBI. We conducted a prospective study of patients who were admitted to the neurosurgical department with mTBI, had admission laboratory data available, and a brain CT scan was performed. The cohort included 101 patients (mean age: 59 ± 23.14 years). Falls were the most frequent mechanism of TBI (73.2%). Subdural hematoma (SDH) was the most frequent type of intracranial injury (31.7%), followed by contusions (28.7%), and subarachnoid hemorrhage (22.7%). Patients with intracranial trauma had higher neutrophil-to- lymphocyte (NLR) ratio (p = 0.042) and higher glucose levels (p = 0.021) than patients with concussion. Additionally, patients with SDH had significantly higher NLR and glucose levels than patients with other intracranial trauma concussion. ROC analysis showed that NLR and glucose discriminated SDH from contusion with AUCs of 0.74 (95% CI: 0.59 – 0.89) and 0.80 (95% CI: 0.7–0.9), respectively. These findings require validation in larger cohorts and suggest a meaningful role of routine biomarkers in the emergency management of mTBI. However, the single-center design and modest sample size, exclusion of patients suffering from multiple injuries, diabetes or hematologic diseases may affect measured associations.