The neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of clinical outcome of different diseases, such as acute ischemic stroke, intracerebral hemorrhage, malignant tumor, and traumatic brain injury (TBI). However, the prognostic value of NLR plus admission GCS score (NLR-GCS) is still unclear in patients with diffuse axonal injury (DAI). Therefore, this study assessed the relationship between the NLR-GCS and the 6-month outcome of DAI patients.
The clinical characteristics of DAI patients admitted to our department between January 2014 and January 2020 were retrospectively analyzed. The candidate risk factors were screened by using univariate analysis, and the independence of resultant risk factors was evaluated by the binary logistic regression analysis and least absolute shrinkage and selection operator (LASSO) regression analysis. The predictive value of NLR-GCS in an unfavorable outcome was assessed by the Receiver Operating Characteristics (ROC) curve analysis.
A total of 93 DAI patients were included. Binary logistic regression analysis and LASSO regression analysis showed the level of NLR on admission was an independent risk factor of unfavorable outcomes in DAI patients. The ROC curve analysis showed that the predictive capacity of the combination of NLR and admission GCS score and the combination of NLR and Coma duration outperformed NLR, admission GCS score, and Coma duration alone.
The higher NLR level on admission is independently associated with unfavorable outcomes of DAI patients at 6 months. Furthermore, the combination of NLR and admission GCS score provides the superior predictive capacity to either NLR or GCS alone.

Copyright © 2021. Published by Elsevier Inc.