Research Article
BibTex RIS Cite

Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism

Year 2018, Volume: 8 Issue: 2, 111 - 116, 17.05.2018
https://doi.org/10.16899/gopctd.410396

Abstract

Objective: The aim of our study was to investigate clinical
importance of neutrophil to lymphocyte ratio (NLR) and plateled to lymphocyte
ratio (PLR) in patients with acute pulmonary embolism (PE).

Methods: 50 patients with a diagnosis of acute PE included
into the study between January 2016 and December 2017. NLR level was measured
by dividing neutrophil count to lymphocyte count. PLR level was measured by
dividing plateled count to lymphocyte count. Pre-treatment and post-treatment
groups of NLR and PLR values were compared.

Results: It has been NLR and PLR ratio have a significantly
higher value in admission and patients with pre-treatment groups were found
statistically significant variable to predict the treatment effects. Also,
correlation analysis showed a significant correlation between NLR and PLR.







Conclusion: NLR and PLR values
may be a useful biomarker for risk stratification and also prognosis for PE.

References

  • Goldhaber S, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353(9162):1386-9.
  • Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, et al. (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007;98:756-64.
  • Aujesky D, Obrosky DS, Stone RA, Auble TE, Perrier A, Cornuz J, et al. A prediction rule to identify low-risk patients with pulmonary embolism. Arch Intern Med 2006;166:169-75.
  • Kayrak M, Erdoğan HI, Solak Y, Akilli H, Gül EE, Yildirim O, et al.Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a restrospective study. Heart Lung Circ 2014;23(1):56-62.
  • Trujillo-Santos J, Di Micco P, Iannuzzo M, Lecumberri R, Guijarro R, Madridano O, et al. Elevated white blood cell count and outcome in cancer patients with venous thromboembolism. Findings from the RIETE Registry. Thromb Haemost 2008;100(5):905-11.
  • Zhu L, Wang C, Yang YH, Wu YF, Zhai ZG. Prognostic value of right ventricular dysfunction and derivation of a prognostic model for patients with acute pulmonary thromboembolism. Zhonghua Liu Xing Bing Xue Za Zhi 2009;30(2):184-8.
  • Masotti L, Cappelli R. C-reactive protein in elderly patients with suspected and confirmed pulmonary embolism. Clin Appl Thromb Hemost 2007;13(2):221-3.
  • 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.
  • Ciofetta G, Piepsz A, Roca I, Fisher S, Hahn K, Sixt R et al.Guidelines for lung scintigraphy in children.Eur J Nucl Med Mol Imaging 2007;34(9):1518-26.
  • Mahan CE, Borrego ME, Woersching AL, Federici R, Downey R, Tiongson J, et al. Venous thromboembolism: Annualised United States models for total, hospital-acquired and preventable costs utilising long-term attack rates. Thromb Haemost 2012;108:291-302.
  • Ma Y, Mao Y, He X, Sun Y, Huang S, Qiu J. The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism. BMC Cardiovasc Disord 2016;16:123.
  • Konstantinides SV. Trends in incidence versus case fatality rates of pulmonary embolism: Good news or bad news? Thromb Haemost 2016;115:233-5.
  • Smith SB, Geske JB, Maguire JM, Zane NA, Carter RE, Morgenthaler TI. Early anticoagulation is associated with reduced mortality for acute pulmonary embolism. Chest 2010;137:1382-90.
  • Tapson VF, Friedman O.Systemic Thrombolysis for Pulmonary Embolism: Who and How. Tech Vasc Interv Radiol 2017;20(3):162-174.
  • Merli GJ. Pulmonary Embolism in 2017: How We Got Here and Where Are We Going? Tech Vasc Interv Radiol 2017;20(3):128-134.
  • Afzal A, Noor HA, Gill SA, Brawner C, Stein PD. Leukocytosis in acute pulmonary embolism. Chest 1999;115(5):1329-32.
  • Kaya MG, Akpek M, Lam YY, Yarlioglues M, Celik T, Gunebakmaz O, et al. Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention: a prospective, multicenter study. Int J Cardiol. 2013; 168: 1154-9.
  • Kosumi K, Baba Y, Ishimoto T, Harada K, Nakamura K, Ohuchi M, et al. Neutrophil/lymphocyte ratio predicts the prognosis in esophageal squamous cell carcinoma patients. Surg Today 2016;46:405-13.
  • Akgullu C, Omurlu IK, Eryilmaz U, Avcil M, Dagtekin E, Akdeniz M, et al. Predictors of early death in patients with acute pulmonary embolism. Am J Emerg Med 2015;33:214-21.
  • Li DB, Hua Q, Liu Z, Li J, Xu LQ, Wang S, et al. Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction. Chin Med J (Engl) 2009;122(15):1738-42.
  • Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 2008;34(1):55-60.
  • Çiçek G, Açıkgoz SK, Bozbay M, Altay S, Uğur M, Uluganyan M, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology 2015;66(5):441-7.
  • Ozcan-Cetin EH, Cetin MS, Canpolat U, Akdi A, Aras D, Temizhan A, et al. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study.Thromb Res 2017;150:33-40.
  • Cavuş UY, Yildirim S, Sönmez E, Ertan C, Ozeke O. Prognostic value of neutrophil/lymphocyte ratio in patients with pulmonary embolism. Turk J Med Sci. 2014;44(1):50-5.
  • Galliazzo S, Nigro O, Bertu L, Guasti L, Grandi AM, Ageno W, Dentali F. Prognostic role of neutrophils to lymphocytes ratio in patients with acute pulmonary embolism: a systematic review and meta-analysis of the literature. Intern Emerg Med 2018 Mar 5. doi: 10.1007/s11739-018-1805-2.
  • Nielsen JM, Mortensen J. The choice of diagnostic modality for acute pulmonary embolism. Ugeskr Laeger 2018;180(8). pii: V05170391.
  • Hasbek Z, Erselcan T, Gül SS. Relationship between scintigraphic findings in ventilation/perfusion scintigraphy and D-dimer levels in diagnosis of pulmonary embolism. Cumhuriyet Med J 2014; 36: 320-6.
  • Hess S, Madsen PH. Radionuclide Diagnosis of Pulmonary Embolism. Adv Exp Med Biol 2017;906:49-65.
  • Le Roux PY, Robin P, Salaun PY. New developments and future challenges of nuclear medicine and molecular imaging for pulmonary embolism. Thromb Res 2017. pii: S0049-3848(17)30394-8.
  • Meng JJ, Zhang LJ, Wang Q, Fang W, Dai HJ, Yan J, et al. A comparison of ventilation/perfusion single photon emission CT and CT pulmonary angiography for diagnosis of pulmonary embolism. Zhonghua Jie He He Hu Xi Za Zhi 2013;36(3):177-81.
  • Zöphel K, Bacher-Stier C, Pinkert J, Kropp J. Ventilation/perfusion lung scintigraphy: what is still needed? A review considering technetium-99m-labeled macro-aggregates of albumin. Ann Nucl Med 2009;23(1):1-16.
  • Isidoro J, Gil P, Costa G, Pedroso de Lima J, Alves C, Ferreira NC. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Phys Med 2017;41:93-96.

Pulmoner Emboli Hastalarında Nötrofil/Lenfosit Oranı ve Trombosit/Lenfosit Oranı

Year 2018, Volume: 8 Issue: 2, 111 - 116, 17.05.2018
https://doi.org/10.16899/gopctd.410396

Abstract

Amaç: Çalışmanın amacı akut pulmoner embolisi olan
hastalarda nötrofil/lenfosit oranının (NLR) ve plateled/lenfosit oranının (PLR)
klinik önemini araştırmaktır.

Yöntem: Ocak 2016 ile Aralık 2017 tarihleri ​​arasında akut pulmoner
emboli tanısı konan 50 hasta çalışmaya dahil edildi. NLR düzeyi, nötrofil
sayısının lenfosit sayısına bölünmesiyle ölçüldü. PLR düzeyi, plateled sayısının
lenfosit sayımına sayısına bölünmesiyle ölçüldü. NLR ve PLR ​​değerlerinin
tedavi öncesi ve tedavi sonrası grupları ile karşılaştırıldı.

Bulgular: Başvuruda NLR ve PLR ​​oranı anlamlı olarak yüksekti ve
tedavi öncesi grupların tedavi etkilerini tahmin etmek için istatistiksel
olarak anlamlı bir değişken olarak bulundu. Ayrıca, NLR ve PLR ​​arasında
anlamlı bir korelasyon saptandı.







Sonuç: NLR ve PLR
​​düzeyleri tedavi sonrası komorbidite için risk sınıflandırmasında yararlı ve
invazif olmayan bir biyobelirteç olabilir.

References

  • Goldhaber S, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353(9162):1386-9.
  • Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, et al. (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007;98:756-64.
  • Aujesky D, Obrosky DS, Stone RA, Auble TE, Perrier A, Cornuz J, et al. A prediction rule to identify low-risk patients with pulmonary embolism. Arch Intern Med 2006;166:169-75.
  • Kayrak M, Erdoğan HI, Solak Y, Akilli H, Gül EE, Yildirim O, et al.Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a restrospective study. Heart Lung Circ 2014;23(1):56-62.
  • Trujillo-Santos J, Di Micco P, Iannuzzo M, Lecumberri R, Guijarro R, Madridano O, et al. Elevated white blood cell count and outcome in cancer patients with venous thromboembolism. Findings from the RIETE Registry. Thromb Haemost 2008;100(5):905-11.
  • Zhu L, Wang C, Yang YH, Wu YF, Zhai ZG. Prognostic value of right ventricular dysfunction and derivation of a prognostic model for patients with acute pulmonary thromboembolism. Zhonghua Liu Xing Bing Xue Za Zhi 2009;30(2):184-8.
  • Masotti L, Cappelli R. C-reactive protein in elderly patients with suspected and confirmed pulmonary embolism. Clin Appl Thromb Hemost 2007;13(2):221-3.
  • 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.
  • Ciofetta G, Piepsz A, Roca I, Fisher S, Hahn K, Sixt R et al.Guidelines for lung scintigraphy in children.Eur J Nucl Med Mol Imaging 2007;34(9):1518-26.
  • Mahan CE, Borrego ME, Woersching AL, Federici R, Downey R, Tiongson J, et al. Venous thromboembolism: Annualised United States models for total, hospital-acquired and preventable costs utilising long-term attack rates. Thromb Haemost 2012;108:291-302.
  • Ma Y, Mao Y, He X, Sun Y, Huang S, Qiu J. The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism. BMC Cardiovasc Disord 2016;16:123.
  • Konstantinides SV. Trends in incidence versus case fatality rates of pulmonary embolism: Good news or bad news? Thromb Haemost 2016;115:233-5.
  • Smith SB, Geske JB, Maguire JM, Zane NA, Carter RE, Morgenthaler TI. Early anticoagulation is associated with reduced mortality for acute pulmonary embolism. Chest 2010;137:1382-90.
  • Tapson VF, Friedman O.Systemic Thrombolysis for Pulmonary Embolism: Who and How. Tech Vasc Interv Radiol 2017;20(3):162-174.
  • Merli GJ. Pulmonary Embolism in 2017: How We Got Here and Where Are We Going? Tech Vasc Interv Radiol 2017;20(3):128-134.
  • Afzal A, Noor HA, Gill SA, Brawner C, Stein PD. Leukocytosis in acute pulmonary embolism. Chest 1999;115(5):1329-32.
  • Kaya MG, Akpek M, Lam YY, Yarlioglues M, Celik T, Gunebakmaz O, et al. Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention: a prospective, multicenter study. Int J Cardiol. 2013; 168: 1154-9.
  • Kosumi K, Baba Y, Ishimoto T, Harada K, Nakamura K, Ohuchi M, et al. Neutrophil/lymphocyte ratio predicts the prognosis in esophageal squamous cell carcinoma patients. Surg Today 2016;46:405-13.
  • Akgullu C, Omurlu IK, Eryilmaz U, Avcil M, Dagtekin E, Akdeniz M, et al. Predictors of early death in patients with acute pulmonary embolism. Am J Emerg Med 2015;33:214-21.
  • Li DB, Hua Q, Liu Z, Li J, Xu LQ, Wang S, et al. Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction. Chin Med J (Engl) 2009;122(15):1738-42.
  • Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 2008;34(1):55-60.
  • Çiçek G, Açıkgoz SK, Bozbay M, Altay S, Uğur M, Uluganyan M, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology 2015;66(5):441-7.
  • Ozcan-Cetin EH, Cetin MS, Canpolat U, Akdi A, Aras D, Temizhan A, et al. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study.Thromb Res 2017;150:33-40.
  • Cavuş UY, Yildirim S, Sönmez E, Ertan C, Ozeke O. Prognostic value of neutrophil/lymphocyte ratio in patients with pulmonary embolism. Turk J Med Sci. 2014;44(1):50-5.
  • Galliazzo S, Nigro O, Bertu L, Guasti L, Grandi AM, Ageno W, Dentali F. Prognostic role of neutrophils to lymphocytes ratio in patients with acute pulmonary embolism: a systematic review and meta-analysis of the literature. Intern Emerg Med 2018 Mar 5. doi: 10.1007/s11739-018-1805-2.
  • Nielsen JM, Mortensen J. The choice of diagnostic modality for acute pulmonary embolism. Ugeskr Laeger 2018;180(8). pii: V05170391.
  • Hasbek Z, Erselcan T, Gül SS. Relationship between scintigraphic findings in ventilation/perfusion scintigraphy and D-dimer levels in diagnosis of pulmonary embolism. Cumhuriyet Med J 2014; 36: 320-6.
  • Hess S, Madsen PH. Radionuclide Diagnosis of Pulmonary Embolism. Adv Exp Med Biol 2017;906:49-65.
  • Le Roux PY, Robin P, Salaun PY. New developments and future challenges of nuclear medicine and molecular imaging for pulmonary embolism. Thromb Res 2017. pii: S0049-3848(17)30394-8.
  • Meng JJ, Zhang LJ, Wang Q, Fang W, Dai HJ, Yan J, et al. A comparison of ventilation/perfusion single photon emission CT and CT pulmonary angiography for diagnosis of pulmonary embolism. Zhonghua Jie He He Hu Xi Za Zhi 2013;36(3):177-81.
  • Zöphel K, Bacher-Stier C, Pinkert J, Kropp J. Ventilation/perfusion lung scintigraphy: what is still needed? A review considering technetium-99m-labeled macro-aggregates of albumin. Ann Nucl Med 2009;23(1):1-16.
  • Isidoro J, Gil P, Costa G, Pedroso de Lima J, Alves C, Ferreira NC. Radiation dose comparison between V/P-SPECT and CT-angiography in the diagnosis of pulmonary embolism. Phys Med 2017;41:93-96.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Serdar Savaş Gül 0000-0003-4822-2588

Nurşah Başol 0000-0002-0883-6553

Publication Date May 17, 2018
Acceptance Date April 29, 2018
Published in Issue Year 2018 Volume: 8 Issue: 2

Cite

APA Gül, S. S., & Başol, N. (2018). Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism. Çağdaş Tıp Dergisi, 8(2), 111-116. https://doi.org/10.16899/gopctd.410396
AMA Gül SS, Başol N. Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism. J Contemp Med. June 2018;8(2):111-116. doi:10.16899/gopctd.410396
Chicago Gül, Serdar Savaş, and Nurşah Başol. “Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients With Pulmonary Embolism”. Çağdaş Tıp Dergisi 8, no. 2 (June 2018): 111-16. https://doi.org/10.16899/gopctd.410396.
EndNote Gül SS, Başol N (June 1, 2018) Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism. Çağdaş Tıp Dergisi 8 2 111–116.
IEEE S. S. Gül and N. Başol, “Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism”, J Contemp Med, vol. 8, no. 2, pp. 111–116, 2018, doi: 10.16899/gopctd.410396.
ISNAD Gül, Serdar Savaş - Başol, Nurşah. “Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients With Pulmonary Embolism”. Çağdaş Tıp Dergisi 8/2 (June 2018), 111-116. https://doi.org/10.16899/gopctd.410396.
JAMA Gül SS, Başol N. Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism. J Contemp Med. 2018;8:111–116.
MLA Gül, Serdar Savaş and Nurşah Başol. “Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients With Pulmonary Embolism”. Çağdaş Tıp Dergisi, vol. 8, no. 2, 2018, pp. 111-6, doi:10.16899/gopctd.410396.
Vancouver Gül SS, Başol N. Neutrophil to Lymphocyte Ratio and Plateled to Lymphocyte Ratio in Patients with Pulmonary Embolism. J Contemp Med. 2018;8(2):111-6.