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Hematolojik Parametreler Akut Pankreatitin Şiddetini Öngörebiliyor mu?

Year 2020, , 79 - 83, 30.08.2020
https://doi.org/10.18678/dtfd.684148

Abstract

Amaç: Nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO), ortalama trombosit hacmi (MPV) ve eritrosit dağılım genişliğinin (RDW) sistemik inflamasyon ile ilişkili olduğu kabul edilir. Bu çalışmada, akut pankreatitte (AP) prognostik faktörler olarak NLO, TLO, MPV ve RDW değerlerinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Mayıs 2016 ile Mayıs 2019 tarihleri arasında Sağlık Bilimleri Üniversitesi Gazi Yaşargil Eğitim ve Araştırma Hastanesine başvuran ve AP tanısı konulan toplam 315 hasta çalışmaya dahil edildi. Hasta verileri retrospektif olarak analiz edildi. Hastaların hastaneye başvuru zamanındaki laboratuvar değerleri kaydedildi ve Ranson skoru hesaplandı. Hastalar, Ranson skoru <3 (hafif AP) ve ≥3 (şiddetli AP) olanlar şeklinde iki gruba ayrıldı. Bu gruplar arasında NLO, TLO, MPV ve RDW parametreleri karşılaştırıldı.
Bulgular: Hastaların 103’ü (%32,7) erkek ve 212’si (%67,3) kadın olup yaş ortalaması 57,2±19,5 idi. Ranson kriterlerine göre skoru 3’ün altında olan hasta sayısı 274 (%87,0), skoru 3 ve üstünde olan hasta sayısı ise 41 (%13,0) olarak saptandı. Şiddetli AP grubunda NLO ve PLO, hafif AP grubuna göre anlamlı derecede yüksekti (sırasıyla 16,2±14,3'e karşı 8,2±7,7; p<0,001 ve 283,7±223,0 karşı 195,5±139,3; p=0,004), ancak RDW-CV ve MPV açısından istatistiksel olarak anlamlı bir farklılık yoktu (sırasıyla 13,7±1,0'e karşılık 13,9±1,9; p=0,849 ve 9,7±1,3'e karşı 9,5±1,1; p=0,201).
Sonuç: NLO ve PLO, AP şiddetini belirlemek için kullanabilecek olan basit ve güvenli testlerdir.

References

  • Cavallini G, Frulloni L, Bassi C, Gabbrielli A, Castoldi L, Costamagna G, et al. Prospective multicentre survey on acute pancreatitis in Italy (ProInf-AISP): Results on 1005 patients. Dig Liver Dis. 2004;36(3):205-11.
  • Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81.
  • Blamey SL, Imrie CW, O’Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut. 1984;25(12):1340-6.
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med. 1985;13(10):818-29.
  • Balthazar EJ, Freeny PC, vanSonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994;193(2):297-306.
  • Dambrauskas Z, Gulbinas A, Pundzius J, Barauskas G. Value of the different prognostic systems and biological markers for predicting severity and progression of acute pancreatitis. Scand J Gastroenterol. 2010;45(7-8): 959-70.
  • de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care. 2010;14(5):R192.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.
  • Han C, Zeng J, Lin R, Liu J, Qian W, Ding Z, et al. The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis. Sci Rep. 2017;7(1):10704.
  • Westerdijk K, Simons KS, Zegers M, Wever PC, Pickkers P, de Jager CPC. The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the intensive care unit: A retrospective cohort study. PLoS One. 2019;14(2):e0212861.
  • Prajapati JH, Sahoo S, Nikam T, Shah KH, Maheriya B, Parmar M. Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients. J Lipids. 2014;2014:686791.
  • Ubukata H, Motohashi G, Tabuchi T, Nagata H, Konishi S, Tabuchi T. Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ratio as prognostic indicators in gastric cancer patients. J Surg Oncol. 2010;102(7):742-7.
  • Uçmak F, Yılmaz A, Ekin N, Tuncer E.T, Fırat U, Palancı Y. Neutrophil-to-lymphocyte ratio in the prediction of microscopic colitis. J Clin Anal Med. 2015;6(Suppl 4): 492-5.
  • Järemo P, Lindahl TL, Lennmark C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-8.
  • Azab B, Jaglall N, Atallah JP, Lamet A, Raja-Surya V, Farah B, et al. Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology. 2011;11(4):445-52.
  • Suppiah A, Malde D, Arab T, Hamed M, Allgar V, Smith AM, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4):675-81.
  • Kokulu K, Günaydın YK, Akıllı NB, Köylü R, Sert ET, Köylü Ö, et al. Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol. 2018;29(6):684-91.
  • Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114(3):449-58.
  • Smith RA, Bosonnet L, Ghaneh P, Sutton R, Evans J, Healey P, et al. The platelet-lymphocyte ratio improves the predictive value of serum CA19-9 levels in determining patient selection for staging laparoscopy in suspected periampullary cancer. Surgery. 2008;143(5):658-66.
  • Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012;34(3):326-34.
  • Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014;23(7):1204-12.
  • Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol. 2014;12:58.
  • Kaya Y, Düğeroğlu H, Çınar H. Relation of platelet to lymphocyte ratio with the severity of acute pancreatitis. FÜ Sağ Bil Tıp Derg. 2017;31(3):137-41.
  • Cho SK, Jung S, Lee KJ, Kim JW. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis. BMC Gastroenterol. 2018;18(1):18.
  • Okuturlar Y, Soylu A, Dogan H, Cakmak S, Kirac Utku I, Oztosun B, et al. Mean platelet volume in patients with biliary and non-biliary acute pancreatitis. Int J Clin Exp Pathol. 2015;8(2):2051-6.
  • Lei JJ, Zhou L, Liu Q, Xiong C, Xu CF. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol. 2017;23(13):2404-13.
  • Akbal E, Demirci S, Koçak E, Köklü S, Başar O, Tuna Y. Alterations of platelet function and coagulation parameters during acute pancreatitis. Blood Coagul Fibrinolysis. 2013;24(3):243-6.
  • Zhang FX, Li ZL, Zhang ZD, Ma XC. Prognostic value of red blood cell distribution width for severe acute pancreatitis. World J Gastroenterol. 2019;25(32):4739-48.
  • Önmez A, Bilir E, Torun S. The relationship between acute pancreatitis severity of platelet lymphocyte ratio, neutrophil lymphocyte ratio, erythrocyte distribution width and mean platelet volume. Konuralp Med J. 2019;11(1):24-9.

Can Hematological Parameters Predict the Severity of Acute Pancreatitis?

Year 2020, , 79 - 83, 30.08.2020
https://doi.org/10.18678/dtfd.684148

Abstract

Aim: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and erythrocyte distribution width (RDW) are considered to be associated with systemic inflammation. In this study, it was aimed to evaluate NLR, PLR, MPV and RDW as prognostic factors in acute pancreatitis (AP).
Material and Methods: A total of 315 patients admitted to Health Sciences University Gazi Yaşargil Training and Research Hospital between May 2016 and May 2019 and diagnosed with AP were included in the study. Data of the patients were analyzed retrospectively. Laboratory values of the patients at the time of admission to the hospital were recorded and the Ranson score was calculated. Patients were divided into two groups as Ranson score <3 (mild AP) and ≥3 (severe AP). NLR, PLR, MPV and RDW parameters were compared between these groups.
Results: Of the patients, 103 (32.7%) were males and 212 (67.3%) were females, and mean age was 57.2±19.5. According to the Ranson criteria, number of patients with a score below 3 was 274 (87.0%), and number of patients with a score of 3 or above was 41 (13.0%). In the severe AP group, NLR and PLR were significantly higher than in the mild AP group (16.2±14.3 vs. 8.2±7.7, p<0.001 and 283.7±223.0 vs. 195.5±139.3, p=0.004 respectively), but there was no statistically significant difference in terms of RDW-CV and MPV (13.7±1.0 vs. 13.9±1.9, p=0.849 and 9.7±1.3 vs. 9.5±1.1, p=0.201, respectively).
Conclusion: NLR and PLR are simple and safe tests that can be used to determine the severity of AP.

References

  • Cavallini G, Frulloni L, Bassi C, Gabbrielli A, Castoldi L, Costamagna G, et al. Prospective multicentre survey on acute pancreatitis in Italy (ProInf-AISP): Results on 1005 patients. Dig Liver Dis. 2004;36(3):205-11.
  • Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81.
  • Blamey SL, Imrie CW, O’Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut. 1984;25(12):1340-6.
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med. 1985;13(10):818-29.
  • Balthazar EJ, Freeny PC, vanSonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994;193(2):297-306.
  • Dambrauskas Z, Gulbinas A, Pundzius J, Barauskas G. Value of the different prognostic systems and biological markers for predicting severity and progression of acute pancreatitis. Scand J Gastroenterol. 2010;45(7-8): 959-70.
  • de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care. 2010;14(5):R192.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.
  • Han C, Zeng J, Lin R, Liu J, Qian W, Ding Z, et al. The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis. Sci Rep. 2017;7(1):10704.
  • Westerdijk K, Simons KS, Zegers M, Wever PC, Pickkers P, de Jager CPC. The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the intensive care unit: A retrospective cohort study. PLoS One. 2019;14(2):e0212861.
  • Prajapati JH, Sahoo S, Nikam T, Shah KH, Maheriya B, Parmar M. Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients. J Lipids. 2014;2014:686791.
  • Ubukata H, Motohashi G, Tabuchi T, Nagata H, Konishi S, Tabuchi T. Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ratio as prognostic indicators in gastric cancer patients. J Surg Oncol. 2010;102(7):742-7.
  • Uçmak F, Yılmaz A, Ekin N, Tuncer E.T, Fırat U, Palancı Y. Neutrophil-to-lymphocyte ratio in the prediction of microscopic colitis. J Clin Anal Med. 2015;6(Suppl 4): 492-5.
  • Järemo P, Lindahl TL, Lennmark C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest. 2000;30(12):1113-8.
  • Azab B, Jaglall N, Atallah JP, Lamet A, Raja-Surya V, Farah B, et al. Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology. 2011;11(4):445-52.
  • Suppiah A, Malde D, Arab T, Hamed M, Allgar V, Smith AM, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4):675-81.
  • Kokulu K, Günaydın YK, Akıllı NB, Köylü R, Sert ET, Köylü Ö, et al. Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol. 2018;29(6):684-91.
  • Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114(3):449-58.
  • Smith RA, Bosonnet L, Ghaneh P, Sutton R, Evans J, Healey P, et al. The platelet-lymphocyte ratio improves the predictive value of serum CA19-9 levels in determining patient selection for staging laparoscopy in suspected periampullary cancer. Surgery. 2008;143(5):658-66.
  • Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012;34(3):326-34.
  • Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014;23(7):1204-12.
  • Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol. 2014;12:58.
  • Kaya Y, Düğeroğlu H, Çınar H. Relation of platelet to lymphocyte ratio with the severity of acute pancreatitis. FÜ Sağ Bil Tıp Derg. 2017;31(3):137-41.
  • Cho SK, Jung S, Lee KJ, Kim JW. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis. BMC Gastroenterol. 2018;18(1):18.
  • Okuturlar Y, Soylu A, Dogan H, Cakmak S, Kirac Utku I, Oztosun B, et al. Mean platelet volume in patients with biliary and non-biliary acute pancreatitis. Int J Clin Exp Pathol. 2015;8(2):2051-6.
  • Lei JJ, Zhou L, Liu Q, Xiong C, Xu CF. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol. 2017;23(13):2404-13.
  • Akbal E, Demirci S, Koçak E, Köklü S, Başar O, Tuna Y. Alterations of platelet function and coagulation parameters during acute pancreatitis. Blood Coagul Fibrinolysis. 2013;24(3):243-6.
  • Zhang FX, Li ZL, Zhang ZD, Ma XC. Prognostic value of red blood cell distribution width for severe acute pancreatitis. World J Gastroenterol. 2019;25(32):4739-48.
  • Önmez A, Bilir E, Torun S. The relationship between acute pancreatitis severity of platelet lymphocyte ratio, neutrophil lymphocyte ratio, erythrocyte distribution width and mean platelet volume. Konuralp Med J. 2019;11(1):24-9.
There are 29 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Nazım Ekin This is me 0000-0001-5302-8953

Eşref Araç 0000-0001-6041-3817

Songül Araç 0000-0001-6830-3639

Publication Date August 30, 2020
Submission Date February 4, 2020
Published in Issue Year 2020

Cite

APA Ekin, N., Araç, E., & Araç, S. (2020). Can Hematological Parameters Predict the Severity of Acute Pancreatitis?. Duzce Medical Journal, 22(2), 79-83. https://doi.org/10.18678/dtfd.684148
AMA Ekin N, Araç E, Araç S. Can Hematological Parameters Predict the Severity of Acute Pancreatitis?. Duzce Med J. August 2020;22(2):79-83. doi:10.18678/dtfd.684148
Chicago Ekin, Nazım, Eşref Araç, and Songül Araç. “Can Hematological Parameters Predict the Severity of Acute Pancreatitis?”. Duzce Medical Journal 22, no. 2 (August 2020): 79-83. https://doi.org/10.18678/dtfd.684148.
EndNote Ekin N, Araç E, Araç S (August 1, 2020) Can Hematological Parameters Predict the Severity of Acute Pancreatitis?. Duzce Medical Journal 22 2 79–83.
IEEE N. Ekin, E. Araç, and S. Araç, “Can Hematological Parameters Predict the Severity of Acute Pancreatitis?”, Duzce Med J, vol. 22, no. 2, pp. 79–83, 2020, doi: 10.18678/dtfd.684148.
ISNAD Ekin, Nazım et al. “Can Hematological Parameters Predict the Severity of Acute Pancreatitis?”. Duzce Medical Journal 22/2 (August 2020), 79-83. https://doi.org/10.18678/dtfd.684148.
JAMA Ekin N, Araç E, Araç S. Can Hematological Parameters Predict the Severity of Acute Pancreatitis?. Duzce Med J. 2020;22:79–83.
MLA Ekin, Nazım et al. “Can Hematological Parameters Predict the Severity of Acute Pancreatitis?”. Duzce Medical Journal, vol. 22, no. 2, 2020, pp. 79-83, doi:10.18678/dtfd.684148.
Vancouver Ekin N, Araç E, Araç S. Can Hematological Parameters Predict the Severity of Acute Pancreatitis?. Duzce Med J. 2020;22(2):79-83.