Predictive value of hematologic indices on weaning from mechanical ventilation and 30-day mortality in patients with traumatic brain injury in an intensive care unit: A retrospective analysis of MIMIC-IV data

The management of traumatic brain injury (TBI) in intensive care units is dependent on the wise use of life-support systems. This study investigated the utility of various hematologic indices to predict successful weaning and risk of short-term mortality in TBI patients. Data of patients with TBI requiring mechanical ventilation were extracted from the MIMIC-IV database and retrospectively reviewed. Successful weaning was defined as no re-intubation or death within 48 ​h, non-invasive ventilation under 48 ​h post-extubation, and passing a spontaneous breathing test with specific respiratory and cardiovascular stability criteria. The systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and glucose-to-lymphocyte ratio (GLR) were evaluated for their predictive value using logistic regression and receiver operating characteristic (ROC) analyses. A total of 414 patients were included. After adjustment, higher PLR and GLR (adjusted odds ratio [aOR] ​= ​0.766, 95 ​% confidence interval [CI]: 0.66-0.89) and GLR (aOR ​= ​0.761, 95 ​% CI: 0.65-0.89) were significantly associated with a lower likelihood of weaning success, while higher NLR (aOR ​= ​1.70, 95 ​% CI: 1.18-2.45) was associated with increased 30-day mortality. The area under the ROC curve (AUC) values for predicting weaning success were 0.636 for PLR and 0.634 for GLR. NLR showed good predictive accuracy for 30-day mortality with an AUC ​= ​0.752. In conclusions, in patients with TBI, PLR, GLR, and NLR may serve as predictors of mechanical ventilation weaning success and 30-day mortality.