Evaluation of the effect of hematological inflammation markers on prognosis in trauma patients

Evaluating the Effect of Hematological Inflammation Markers on Prognosis in Trauma Patients Objective: Childhood trauma is a major global cause of morbidity and mortality. Inflammatory responses following trauma can significantly influence prognosis. Hematological inflammation markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV) are considered indicators of inflammation. However, data on their prognostic value in pediatric trauma are limited. This study aimed to assess the relationship between these markers and prognosis in pediatric trauma patients. Material and Method: This retrospective study included pediatric trauma patients admitted to the intensive care unit of Akdeniz University Hospital between 2014 and 2024. Patient demographics, trauma characteristics, severity scores (PRISM-III, PELOD-II, PIM-III, ISS, VIS), need for surgery and transfusion, length of mechanical ventilation, ICU/hospital stay, and mortality were recorded. NLR, PLR, SII, SIRI, and PIV values were calculated from hemograms within the first 24 hours of admission. Results: A total of 208 trauma patients (mean age 6.9±5.03 years; 60.1% male) were included. Falls from height (50%) and head trauma (95.2%) were the most common trauma types. Mortality rate was 6.7%. Non-survivors had significantly lower hemoglobin, hematocrit, platelet count, PLR, SII, and PIV values (p<0.05). No significant differences in NLR and SIRI were observed between survivors and non-survivors. Mortality was significantly associated with higher PRISM-III, PELOD-II, PIM-III, ISS, and VIS scores, and lower GCS (p<0.001). Conclusion: PRISM-III, PELOD-II, PIM-III, ISS, and VIS scores are reliable mortality predictors in pediatric trauma. Low PLR, SII, PIV, and platelet counts may be associated with poor outcomes. Further multi-center prospective studies are needed to validate these findings. Keywords: Hematological inflammation, pediatric intensive care, trauma patients