Mortality prediction in patients with acute brain injury using peripheral blood cell analysis: a retrospective study

Introduction
Acute brain injury remains a reason for high mortality as well as a cause of long-term disability among patients hospitalized in the intensive care unit (ICU). Moreover, this injury induces a cascade of changes among morphotic blood cells.

Aim of the research
Our study was to evaluate the most accurate predictor derived from peripheral blood cell counts for 30-day mortality in patients suffering from acute brain injury with intracranial bleeding, and therefore to determine whether simple indices based on blood morphology can predict mortality in acute brain injury. Material and methods: This is a retrospective study of 71 patients presenting with an acute brain injury with intracranial bleeding, hospitalized in the ICU. Daily changes in the blood morphology and ratios between the blood cells were statistically analyzed in terms of clinical data as comorbidities.

Results and conclusions
The groups differed in terms of length of hospitalization and ICU stay, age, GCS after first assessment, along with SAPS II and APACHE II scores. Coefficients of variation were significant in platelet count throughout 72 hours of observation. Although the PLT:WBC ratio on day 2 was found to be statistically significant, with AUC estimated as satisfactory, in a multivariate analysis it did not fulfil the conditions of an independent factor able to predict the assumed short-term mortality period. No universal biomarker for predicting 30-day mortality can be defined for this heterogeneous group of patients after acute brain injury with intracranial bleeding.