The Role of Neutrophil to Lymphocyte Ratio in Prognosis of Spinal Cord Injury: A Systematic Review and Meta-analysis (P4-4.002)

Objective: We aimed to evaluate the prognostic value of Neutrophil-to-lymphocyte ratio in Spinal cord injury patients. Background: Spinal cord injury (SCI) is a debilitating condition linked to long-term morbidity and significant quality-of-life impacts. Accurate prognostication for SCI patients is crucial for informing treatment strategies, managing expectations, and enhancing outcomes. The neutrophil-to-lymphocyte ratio (NLR) shows potential as a reliable prognostic marker for SCI, necessitating further research to confirm its clinical utility and routine application. Design/Methods: We conducted a thorough search of electronic databases, including PubMed, Europe PMC, Science Direct, and Google Scholar, using relevant keywords such as neutrophil-to-lymphocyte ratio, spinal cord injury, prognosis, and outcome along with Boolean operators. Our selection included studies related to SCI and NLR, emphasizing outcomes like functional recovery, ASIA scores, neurological improvement, and long-term survival, while excluding case reports, reviews, commentaries, editorials, and animal studies. Results: Three studies with a total of 997 patients met the inclusion criteria. Our study found that a higher NLR was associated with worse prognosis (MD = 10.36, 95% CI [2.01, 18.72], p = 0.02, I 2 = 97%). The odds ratio (OR) was 0.83 (95% CI [0.63, 1.09], p = 0.18, I 2 = 80%). The AUC value indicated good discrimination ability (AUC = 0.83, 95% CI [0.70 to 0.97], p < 0.01, I 2 = 98%), though high heterogeneity may complicate interpretation. Conclusions: Higher NLR values are associated with worse outcomes. Significant heterogeneity and limited findings from current studies may complicate interpretation. Future research should prioritize larger studies with wider coverage. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: Author has nothing to discloseUtsav Patel has nothing to disclose. Author has nothing to discloseDr. Arya has nothing to disclose. Dr. Karve has nothing to disclose. Author has nothing to discloseDr. Sarvaiya has nothing to disclose. Alan Kaye has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Heliyon Journal. Alan Kaye has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pain Physician Journal. Alan Kaye has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. Dr. Kataria has nothing to disclose.