Comparison of the Predictive Strength of Total White Blood Cell Count Within 24 Hours on Outcome of Traumatic Brain Injury with Glasgow Coma Score and Pupillary Reactivity

Abstract

Background: Clinical parameters such as Glasgow coma score (GCS) and pupillary reactivity (PR) have been identified as useful indicators for predicting traumatic brain injury (TBI). Total white blood cell (WBC) count is a laboratory test whose role in predicting TBI is still at low ebb. It is known to be elevated due to varied reasons in traumatic brain injury and this has been found to correlate with poor outcome. Our study aimed to establish if the predictive strength of total WBC count can be compared with other known outcome models (GCS score and PR). Methodology: This research was done as a hospital based prospective study of 158 patients who presented with isolated TBI within 24 hours of injury over a one-year period from October 2014-September 2015. Total white blood cell count was assayed within 24 hours of injury and clinical parameters – GCS and PR were assessed within 24 hours of same injury. Data analysis was done using statistical package for social science (SPSS) Illinois Chicago version 21. The P value of <0.05 was taken as significant. Results: In this study the predictive value of total WBC was weak, evident by area under the curve of 0.633 compared to that of total WBC count and PR , which was statistically significant at p<0.001 Conclusion: The predictive strength of total white cell count in patients with traumatic brain injury is weaker compared to clinical tool (PR and GCS) used to predict outcome in TBI.

Keywords: Brain trauma, Clinical parameters, Laboratory test, Glasgow Coma Scale