Blood leukocyte-based clusters in patients with traumatic brain injury

BackgroundLeukocytes play an important role in inflammatory response after a traumatic brain injury (TBI). We designed this study to identify TBI phenotypes by clustering blood levels of various leukocytes.MethodsTBI patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) datab...

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Main Authors: Ruoran Wang, Jianguo Xu, Min He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1504668/full
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author Ruoran Wang
Jianguo Xu
Min He
author_facet Ruoran Wang
Jianguo Xu
Min He
author_sort Ruoran Wang
collection DOAJ
description BackgroundLeukocytes play an important role in inflammatory response after a traumatic brain injury (TBI). We designed this study to identify TBI phenotypes by clustering blood levels of various leukocytes.MethodsTBI patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) database were included. Blood levels of neutrophils, lymphocytes, monocytes, basophils, and eosinophils were collected by analyzing the first blood sample within 24 h since admission. Overall, TBI patients were divided into clusters following the K-means clustering method using blood levels of five types of leukocytes. The correlation between identified clusters and mortality was tested by univariate and multivariate logistic regression analyses. The Kaplan–Meier method was used to verify the survival difference between identified TBI clusters.ResultsA total of 172 (cluster 1), 791 (cluster 2), and 636 (cluster 3) TBI patients were divided into three clusters with the following percentages, 10.8%, 49.5%, and 39.8%, respectively. Cluster 1 had the lowest Glasgow Coma Scale (GCS) and the highest Injury Severity Score (ISS) while cluster 2 had the highest GCS and the lowest ISS. The mortality rates of the three clusters were 25.6%, 13.3%, and 18.1%, respectively. The multivariate logistic regression indicated that cluster 1 had a higher mortality risk (OR = 2.211, p = 0.003) than cluster 2, while cluster 3 did not show a significantly higher mortality risk than cluster 2 (OR = 1.285, p = 0.163). Kapan–Meier analysis showed that cluster 1 had shorter survival than cluster 2 and cluster 3.ConclusionThree TBI phenotypes with different inflammatory statuses and mortality rates were identified based on blood levels of leukocytes. This classification is helpful for physicians to evaluate the prognosis of TBI patients.
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spelling doaj-art-366a66146f4b4247b1e67c01bb73ab822025-01-09T05:10:26ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.15046681504668Blood leukocyte-based clusters in patients with traumatic brain injuryRuoran Wang0Jianguo Xu1Min He2Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaBackgroundLeukocytes play an important role in inflammatory response after a traumatic brain injury (TBI). We designed this study to identify TBI phenotypes by clustering blood levels of various leukocytes.MethodsTBI patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) database were included. Blood levels of neutrophils, lymphocytes, monocytes, basophils, and eosinophils were collected by analyzing the first blood sample within 24 h since admission. Overall, TBI patients were divided into clusters following the K-means clustering method using blood levels of five types of leukocytes. The correlation between identified clusters and mortality was tested by univariate and multivariate logistic regression analyses. The Kaplan–Meier method was used to verify the survival difference between identified TBI clusters.ResultsA total of 172 (cluster 1), 791 (cluster 2), and 636 (cluster 3) TBI patients were divided into three clusters with the following percentages, 10.8%, 49.5%, and 39.8%, respectively. Cluster 1 had the lowest Glasgow Coma Scale (GCS) and the highest Injury Severity Score (ISS) while cluster 2 had the highest GCS and the lowest ISS. The mortality rates of the three clusters were 25.6%, 13.3%, and 18.1%, respectively. The multivariate logistic regression indicated that cluster 1 had a higher mortality risk (OR = 2.211, p = 0.003) than cluster 2, while cluster 3 did not show a significantly higher mortality risk than cluster 2 (OR = 1.285, p = 0.163). Kapan–Meier analysis showed that cluster 1 had shorter survival than cluster 2 and cluster 3.ConclusionThree TBI phenotypes with different inflammatory statuses and mortality rates were identified based on blood levels of leukocytes. This classification is helpful for physicians to evaluate the prognosis of TBI patients.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1504668/fulltraumatic brain injuryleukocytesclustersphenotypesK-means
spellingShingle Ruoran Wang
Jianguo Xu
Min He
Blood leukocyte-based clusters in patients with traumatic brain injury
Frontiers in Immunology
traumatic brain injury
leukocytes
clusters
phenotypes
K-means
title Blood leukocyte-based clusters in patients with traumatic brain injury
title_full Blood leukocyte-based clusters in patients with traumatic brain injury
title_fullStr Blood leukocyte-based clusters in patients with traumatic brain injury
title_full_unstemmed Blood leukocyte-based clusters in patients with traumatic brain injury
title_short Blood leukocyte-based clusters in patients with traumatic brain injury
title_sort blood leukocyte based clusters in patients with traumatic brain injury
topic traumatic brain injury
leukocytes
clusters
phenotypes
K-means
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1504668/full
work_keys_str_mv AT ruoranwang bloodleukocytebasedclustersinpatientswithtraumaticbraininjury
AT jianguoxu bloodleukocytebasedclustersinpatientswithtraumaticbraininjury
AT minhe bloodleukocytebasedclustersinpatientswithtraumaticbraininjury