Karın ağrısı olan geriatrik hastalarda bilgisayarlı tomografideki patolojileri öngörmede laboratuvar testlerinin etkinliği

Year 2024, Volume: 49 Issue: 2, 278 - 286, 30.06.2024

Yaşar Çatal Nazire Ülkü Kır Sinan Genç Ayça Koca Müge Günalp Onur Polat

https://doi.org/10.17826/cumj.1414439

Abstract

Amaç: Çalışmamız, karın ağrısı olan geriatrik hastaların abdominal bilgisayarlı tomografisindeki (BT) klinik olarak anlamlı patolojileri (CSPs) öngörmede laboratuvar testlerinin etkinliğini araştırmayı amaçladı.
Gereç ve Yöntem: Çalışmamız retrospektif bir vaka kontrol çalışmasıdır. Karın ağrısı nedeniyle acil servise başvuran, abdominal BT çekilen ve 65 yaş ve üzerinde olan tüm hastalar çalışmaya dahil edildi. Laboratuvar test sonuçları, başvuru sırasında alınan kan tahlillerinden elde edildi. BT sonuçlarına göre hastalar "CSPs (+)" ve "CSPs (-)" olmak üzere iki gruba ayrıldı. Laboratuvar sonuçları ile CSPs arasındaki ilişki istatistiksel olarak analiz edildi.
Bulgular: Çalışmaya 518 hasta dahil edildi. Hastaların %72,4’ünde BT’de CSPs (+) olduğu saptandı. Alkalen fosfataz (ALP), C-reaktif protein (CRP), beyaz kan hücreleri (WBC), trombosit, nötrofil ve nötrofil lenfosit oranı (NLR) değerleri CSPs (+) hastalarda istatistiksel olarak anlamlı derecede yüksekti. Testlerin optimal kesim değerleri WBC>10.75 (x10˄3/µL), CRP >150.5 (mg/L), NLR>4.4, ALP >92 (u/L) idi. Tüm testlerin receiver operating characteristic eğrisi altında kalan alanı 0.6'nın altındaydı ve tanısal kullanımda yeterli etkinlikte değildi.
Sonuç: Çalışmamız, karın ağrısı olan geriatrik hastalarda laboratuvar parametresi kullanımının BT’deki CSPs’yi öngörmede tek başına yeterli olmayacağını gösterdi.

Keywords

Geriatrik, karın ağrısı, acil servis, tomografi, laboratuvar testleri

Ethical Statement

Çalışma için Ankara Üniversitesi Etik Kuruldan onay alınmıştır.

Effectiveness of laboratory tests in predicting pathologies on computed tomography in geriatric patients with abdominal pain

Abstract

Purpose: Our study aimed to investigate the effectiveness of laboratory tests in predicting clinically significant pathologies (CSPs) on abdominal computed tomography (CT) in geriatric patients with abdominal pain.
Materials and Methods: Our study is a retrospective case-control study. All patients who were admitted to the emergency department due to abdominal pain had an abdominal CT scan and were 65 years of age or older were included in the study. Laboratory test results were obtained from blood tests taken at the time of admission. According to CT results, patients were grouped into two groups: "CSPs (+)" or "CSPs (-)". The relationship between laboratory results and CSPs was analyzed statistically.
Results: Five hundred eighteen patients were included in the study. CSPs (+) were detected on CT in 72.4% of the patients. Alkaline phosphatase (ALP), C-reactive protein (CRP), white blood cells (WBC), platelet, neutrophil, and neutrophil-lymphocyte ratio (NLR) values were statistically significantly higher in CSPs (+) patients. The optimal cut-off values of the tests were WBC>10.75 (x10˄3/µL), CRP >150.5 (mg/L), NLR>4.4, ALP >92 (U/L). The area under the receiver operating characteristic curve of all of these tests was below 0.6 and was not sufficiently effective for diagnostic use.
Conclusion: Our study showed that using laboratory parameters alone would not be sufficient to predict CSPs on CT in geriatric patients with abdominal pain.

Keywords

Geriatric, Abdominal pain, emergency service, tomography, laboratory tests

Ethical Statement

Ethical approval was obtained from the Ankara University Faculty Of Medicine Clinical Research Ethics Board by its decision dated 29/05/2020 and numbered İ5- 290-20.

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