Serum Leukocyte Count (WBC) Levels as an Indicator for Severity of Traumatic Brain Injury in Saudi Arabia Patients

Background: Traumatic brain injury (TBI) is widespread and leads to death and disability in millions of individuals around the world each year. The treatment and improvement of outcome in TBI subjects still remains a challenge. Traumatic brain injury is associated with elevated serum levels of catecholamines. Brain swelling occurring after head trauma is probably an inflammatory response due to intracerebral cytokine production and increased leukocyte adhesion as a result of a direct effect on vascular permeability and leucocyte activation. However, Glascow Coma Score (GCS) is often used as part of the decision tool in major trauma centers. Objective: This study evaluated the association of serum leukocyte (WBC) levels with GCS score as an indicator for severity of TBI in Saudi Arabia Patients. Patients and Methods: This Prospective study included 43 patients with isolated Traumatic Brain Injury from Neurosurgery intensive care unit, Asser Central Hospital, Abha. Serum blood sample was obtained from each patient for WBC count at initial time of admission and on 24 hrs, 72 hrs followed by 1 week. All patients were divided into 3 groups according to their Glasgow Coma Scale scores, Severe GCS (3-8), Moderate GCS (9- 13) and Mild GCS (14-15) during hospital stay. The relationship between these parameters and WBC levels were evaluated by Repeated Measures of Anova and paired t- test statistical method. Results: Significant association between WBC count and GCS score is observed in all three groups using Repeated Measures of Anova Method ( P 0.0001) and the pairwise comparison using paired t test also showed significant association between these groups, Post hoc bonferroni value (P= 0.0021). Conclusion: Leukocyte value exceeding 14.18 x 106/l has a predictive value for poor GCS score. These findings have implications for TBI outcomes research and for protocols and research selection criteria that use the GCS with WBC count. However, greater sample size and longer follow up would aid further documentation.