Prognostic value of early leukocyte fluctuations for recovery from traumatic spinal cord injury

Abstract

Graphical Abstract We describe the systemic white blood cell (WBC) response to human spinal cord injury (SCI) and demonstrate how this is influenced by overall trauma severity, lesion level, and neurological grade on admission. We identify acute neutrophilia as a negative predictor for patient outcomes, the occurrence of which reduces the likelihood of American Spinal Injury Association Impairment Scale (AIS) grade conversion. We further show that lymphopenia during the first week of SCI is typically associated with better recovery, but that higher neutrophil to lympho-cyte ratios early after SCI are associated with infection presentation in at-risk patients. Collectively, the multi-factorial models described in this work allow for better patient stratification and more accurate prediction of their outcomes. Clin. Transl. Med. 2021;11:e272. wileyonlinelibrary.com/journal/ctm2 https://doi.