Blood parameters that can be used in the diagnosis of acute aortic dissection

Yıl 2024, Cilt: 29 Sayı: 1, 7 - 12, 27.01.2024

Busra Bıldık Gökhan Yılmaz Şeref Emre Atiş Bora Çekmen

https://doi.org/10.21673/anadoluklin.1198065

Öz

Aim: Acute aortic dissection is a disease with high mortality and morbidity. Due to its wide range of symptoms, its diagnosis is often challenging, or it can be confused with an acute coronary syndrome, gastrointestinal diseases, or cerebrovascular diseases. Our study aimed to determine the effectiveness of blood parameters in the diagnosis of aortic dissection.

Methods: Our study was a retrospective, cross-sectional study. In the study, patients whose complaints were chest pain were applied to a tertiary emergency department and suspected aortic dissection and had thoracic and abdominal angiography (BTAA) were included in the study. The patients included in the study were divided into two groups according to whether aortic dissection was detected in the BTAA, the “patient group” with aortic dissection and the “control group” without aortic dissection. Demographic data, whole complete blood counts, C-reactive protein (CRP), and creatinine values, were recorded.

Results: 64 patients were included in the study. The mean age was 61.48±14.49 years. The mean age of the aortic dissection group was 56.96±10.37 years, and 64.20±15.98 years in the control group. The mean age of the group with aortic dissection was lower than the control group (p=0.032). The platelet count of the aortic dissection group was 199 109/L [162-260], and the control group’s platelet count was 260 [348-223] (p=0.003). When the platelet value was taken as 199, the sensitivity for aortic dissection was 50.0% (positive predictive value =2.5), the specificity was 80.0% (negative predictive value =0.63) (AUC= 0.725 [0.597-0.853], p=0.003).

Conclusion: Platelet count and age are independent risk factors in the diagnosis of aortic dissection. Low platelet count levels support the diagnosis of aortic dissection.

Anahtar Kelimeler

Aorta, biomarkers, platelets, computed tomography, diagnosis, dissection

Akut aort diseksiyonu tanısında kullanılabilecek kan parametreleri

Öz

Amaç: Akut aort diseksiyonu yüksek mortalite ve morbiditeye sahip bir hastalıktır. Oldukça geniş semptomlara neden olması sebebiyle tanısı sıklıkla atlanmakta veya akut koroner sendom, gastrointestinal hastalıkları veya serebrovasküler hastalıklarla karıştırılabilmektedir. Çalışmamızda, aort diseksiyonu tanısı alan hastalarda bakılan kan parametrelerinin tanıyı belirlemedeki etkinliğini saptamayı hedefledik.

Yöntemler: Çalışmamız retrospektif, kesitsel bir çalışma olarak planlandı. Çalışmamıza üçüncü basamak bir acil servise göğüs ağrısı şikâyeti ile başvuran ve aort diseksiyonundan şüphe edilip, bilgisayarlı toraks ve abdomen anjiografisi (BTAA) çekilen hastalar dâhil edildi. Çalışmaya alınan hastalar iki gruba ayrıldı ve BTAA raporunda aort diseksiyonu saptanıp saptanmamasına göre aort diseksiyonu olanlar “hasta grubu” ve aort diseksiyonu saptanmayanlar ise “kontrol grubu” olarak belirlendi. Hastalara ait yaş, cinsiyet gibi demografik verilerle birlikte, tam kan parametreleri (lökosit, lenfosit, nötrofil, platelet sayıları), C-reaktif protein (CRP), kreatinin değerleri kaydedildi.

Bulgular: Çalışmaya 64 hasta dâhil edildi. Çalışmaya alınan hastaların yaş ortalaması 61,48±14,49 olarak saptandı. Hastalar ve kontrol grubu karşılaştırıldığında, aort diseksiyonu olan grubun yaş ortalaması 56,96±10,37, kontrol grubun ise 64,20±15,98 olarak saptandı. Aort diseksiyonu olan grubun yaş ortalaması kontrol grubuna göre istatistiksel olarak anlamlı bir şekilde daha düşüktü (p=0,032). Aort diseksiyonu olan grubun platelet sayısı 199 109/L [162-260], kontrol grubunun ise 260 109/L [348-223] olarak saptandı (p=0,003). Platelet değeri için yapılan ROC analizinde, değer 199 109/L olarak alındığında, aort diseksiyonu için duyarlılık %50,0 (pozitif prediktif değeri =2,5), özgüllük %80,0 (negatif prediktif değeri =0,63) olarak belirlendi (AUC= 0,725 [0,597-0,853], p=0,003).

Sonuç: Platelet sayısı ve yaş, aort diseksiyonu tanısında bağımsız risk faktörleridir. Düşük platelet sayısı seviyeleri aort diseksiyonu tanısını destekler.

Anahtar Kelimeler

Aort, biyobelirteç, bilgisayarlı tomografi, diseksiyon, platelet, tanı

Kaynakça

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