The Role of Neutrophil–Lymphocyte Ratio as a Mortality Predictor in Blunt Abdominal Trauma Patients with Liver and/or Spleen Injuries Who had Undergone Emergency Exploratory Laparotomy in Prof. Dr. I.G.N.G. Ngoerah Hospital: A Single-Center Study

Introduction: Abdominal trauma, ranked third in frequency after head and thoracic injuries among individuals under 45 years of age, is a leading cause of global mortality, contributing to an estimated 5 million deaths annually. Accurate assessment, including physical examination and contrast-enhanced abdominal computed tomography scans, is imperative for the timely management and prevention of delayed diagnosis complications. Neutrophil–lymphocyte ratio (NLR) was an objective modality, low-cost, and practical tool to predict outcomes in trauma patients. The aim of this study is to investigate the role of NLR in blunt abdominal trauma patients who had undergone emergency laparotomy as a predictor of mortality. Methods: This bidirectional, cohort, observational study examines the relationship between the NLR in blunt abdominal trauma with liver and/or spleen injuries and mortality during hospitalization at Prof. IGNG Ngoerah Hospital, Denpasar. The study encompassed all blunt abdominal trauma patients presenting to the emergency room, employing bidirectional cohort sampling until meeting sample size requirements. Inclusion criteria included those with liver or spleen injuries necessitating emergency laparotomy with complete blood data. Exclusion criteria covered nonconsent, neoplasms, autoimmune disorders, presurgery deaths, or hollow organ injuries. Receiver operating characteristic curve analysis was performed to determine the NLR cutoff value. The data were then analyzed with Chi-square, using 7.29 as the cutoff value of NLR. Results: In this 113 subjects’ study, normality was tested using the Kolmogorov–Smirnov test, revealing nonnormal distribution ( P < 0.05) for all numeric variables. Demographic details and mortality rates were analyzed, with NLR showing potential as a prognostic marker in blunt abdominal trauma cases. The bivariate analysis obtained a relative risk of 1.468 by using 7.29 as the cutoff point of NLR ( P = 0.443). Thus, blunt abdominal trauma patients involving liver and/or splenic injuries undergoing emergency laparotomy with NLR ≥7.29 had a 1.5 times greater risk of mortality compared to those with NLR <7.29. Conclusions: Based on the findings, the NLR predicts mortality in blunt abdominal trauma, but with limited reliability as a stand-alone indicator.