The role of NSE/GCS ratio on the seventh day as an independent predictor of 90-day outcomes in patients with severe traumatic brain injury.

BACKGROUND: Traumatic brain injury (TBI) can lead to secondary damage that affects patient prognosis. Neuron-specific enolase (NSE) in the blood serves as a marker of nerve damage, while the Glasgow Coma Scale (GCS) score indicates the level of consciousness in patients. The ratio of NSE to GCS (NGR) during the perioperative period can help assess the 90-day prognosis in patients with severe TBI. METHODS: This study involved 63 severe TBI patients. We collected their clinical and preadmission lab data. After admission, we provided personalised, comprehensive treatment, including blood tests for interleukin 6 (IL-6), NSE, blood osmotic pressure (OSM), procalcitonin (PCT), and D-dimer (DD). We evaluated the GCS score on Day 7 to calculate NGR. Using logistic regression and the receiver operating characteristic (ROC) curve, we analysed Preadmission NLR0, NSE7, GCS7, and NGR7 on the seventh day of admission. RESULTS: Patients with poor 90-day outcomes were older, had more extended hospital stays, and exhibited higher levels of NLR0 and IL-6 upon admission (all p<0.05). NLR0, NSE7, GCS7 scores, and NGR7 independently predicted poor outcomes in severe TBI patients. NGR7 showed a strong Pearson r value (r=-0.702, p<0.0001) and the highest diagnostic accuracy for 90-day prognosis Šarea under the curve (AUC) = 0.932; 95% CI =0.872-0.993. CONCLUSIONS: NGR on the seventh day post-admission significantly predicts 90-day outcomes in severe TBI patients.