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Therefore, it is essential to identify at-risk patients early to manage their conditions promptly and navigate through the complexities of their illnesses. This study aims to evaluate the prognostic value of platelet count, Neutrophil\/Lymphocyte ratio (NLR) and the Platelets\/Lymphocyte ratio (PLR) in children undergoing medical care in the PICU.Over a period of 6 months, a prospective study involving 91 PICU patients was conducted. Upon admission, patients underwent detailed history-taking, comprehensive systemic evaluations, and standard laboratory tests that encompassed complete blood counts, C-reactive protein levels, coagulation profiles, as well as liver and kidney function assessments. Subsequently, the NLR and PLR values were determined. The median NLR was slightly elevated in non-survivors compared to survivors, whereas the PLR was higher in survivors, although these differences were not statistically significant. Platelet levels emerged as a predictive factor for mortality, with an AUC of 0.748, a cutoff value of 244.5, and a p-value of 0.002. Additionally, NLR showed a negative correlation with the Glasgow coma score and a positive correlation with age, TLC, CRP, and ALT, with correlation coefficients of (\n                    <jats:italic>r<\/jats:italic>\n                    =-0.253,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016), (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.320 ,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.292,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005), (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.242 ,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.027), and (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.256 ,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.028) respectively. While no statistically significant relationship was observed between NLR and PLR and non-survivors, platelet count showed moderate discriminatory performance for prognostic evaluation and may be used as part of early risk stratification in critically ill patients.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-63363-9","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T18:02:40Z","timestamp":1785261760000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the significance of platelet count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in critically ill children"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8904-6536","authenticated-orcid":false,"given":"Aya Osama","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai Ali Sayed","family":"Abdel Ghaney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yomna Ahmed","family":"Hosni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"3","key":"63363_CR1","doi-asserted-by":"publisher","first-page":"e122","DOI":"10.1097\/PCC.0000000000001070","volume":"18","author":"NP Pinto","year":"2017","unstructured":"Pinto, N. 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Pediatr."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63363-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63363-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63363-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:50:14Z","timestamp":1788191414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-63363-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["63363"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-63363-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"18 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2026","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this Article was revised: In the original version of this Article, Aya Osama Mohamed was incorrectly affiliated with 'Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.', 'Pediatric Intensive Care Unit, Cairo University Children Hospital, Cairo, Egypt.', 'The Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University Children Hospital, Cairo, Egypt.', 'Lecturer of Pediatrics and Pediatric Intensive Care Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.' and 'Pediatric Intensive Care Unit, Cairo University Mounira Pediatric Hospital (Abou El Riche), xzs Sayeda Zeinab, Kasr Al Aini, PO Box: 11562, Cairo, Egypt.' Their correct affiliation is: 'Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt'. Additionally, Mai Ali Sayed Abdel Ghaney was incorrectly affiliated with 'Lecturer of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.' Their correct affiliation is 'Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.' Lastly, Yomna Ahmed Hosni was incorrectly affiliated with 'Pediatric Intensive Care Unit, Cairo University Children Hospital, Cairo, and 'Lecturer of Clinical and Chemical Pathology Faculty of Medicine, Cairo University, Cairo, Egypt.' Their correct affiliation is: 'Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.' The original Article has been corrected.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Cairo University School of Medicine ethical committee with institutional review board number (N74-2024). and accordance with the ethical standards as laid down in the Declaration of Helsinki and its later amendments or comparable ethical standards. Al author\u2019s confirmed that written informed consent was obtained from all participants.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"23494"}}