Acil serviste akut iskemik inme şiddeti ve majör damar oklüzyonunu öngörmede MAPH skorunun değerlendirilmesi

Year 2025, Volume: 8 Issue: 6, 1041 - 1048, 25.10.2025

Emine Sarcan , Merve Yazla

https://doi.org/10.32322/jhsm.1774461

Abstract

Amaç: Bu çalışma, ortalama trombosit hacmi (MPV), total protein ve hematokrit gibi kan viskozite göstergelerini birleştiren bir biyobelirteç olan MAPH skorunun, akut iskemik inme (Aİİ) ile geçici iskemik atak (GİA) ayrımında ve acil servise inme şüphesi ile başvuran hastalarda majör damar oklüzyonunu öngörmedeki değerini değerlendirmeyi amaçladı.
Yöntem: Acil servise fokal nörolojik semptomlarla başvuran 226 hasta üzerinde retrospektif bir analiz yapıldı. Difüzyon ağırlıklı manyetik rezonans görüntüleme bulgularına göre hastalar Aİİ ve GİA gruplarına ayrıldı. Demografik özellikler, vital bulgular, laboratuvar parametreleri ve görüntüleme sonuçları kaydedildi. MPV, yaş, hematokrit ve total protein düzeyleri belirlendi. Total protein ve hematokrit değerlerinden yüksek kayma hızı ve düşük kayma hızı hesaplandı. Tanısal performansı değerlendirmek için ROC eğrisi analizi yapıldı.
Bulgular: ROC analizi, MAPH skorunun Aİİ ile GİA ayrımındaki ve majör damar oklüzyonunu öngörmedeki tanısal doğruluğunu gösterdi. Ayrıca skorun NIHSS ≥ 20 ile anlamlı bir korelasyon gösterdiği, bu nedenle inme şiddeti ile ilişkili olduğu saptandı.
Sonuç: MAPH skoru, Aİİ ile GİA’nın ayırt edilmesine ve majör damar oklüzyonunun öngörülmesine yardımcı olan, basit ve pratik bir araç olup acil servis koşullarında inme yönetimini geliştirmektedir.

Keywords

MAPH skoru , akut iskemik inme , geçici iskemik atak , majör damar oklüzyonu , acil tıp

Ethical Statement

Bu çalışma Sağlık Bakanlığı Ankara Etlik Şehir Hastanesi Etik Kurulu tarafından onaylandı (Tarih: 25/09/2024, Karar No: AEŞH-BADEK-2024-893).

Supporting Institution

Yok

Project Number

None

Thanks

Yok

Evaluation of the MAPH score in predicting acute ischemic stroke severity and major vessel occlusion in the emergency department

Abstract

Aims: This study aimed to evaluate the utility of the MAPH score, a biomarker combining blood viscosity indicators such as mean platelet volume (MPV), total protein, and hematocrit, in differentiating acute ischemic stroke (AIS) from transient ischemic attack (TIA) and predicting major vessel occlusion in patients presenting to the emergency department with suspected stroke.
Methods: A retrospective analysis was conducted on 226 patients presenting to the emergency department with focal neurological symptoms. Patients were categorized into AIS and TIA groups based on diffusion-weighted magnetic resonance imaging findings. Data collected included demographic characteristics, vital signs, laboratory parameters, and imaging results. MPV, age, hematocrit, and total protein levels were recorded. High-shear rate and low-shear rate were calculated from total protein and hematocrit values. ROC curve analysis was performed to evaluate diagnostic performance
Results: The ROC analysis demonstrated the diagnostic accuracy of the MAPH score in differentiating AIS from TIA and predicting major vessel occlusion. Additionally, the score showed a significant correlation with NIHSS ≥20, indicating its association with stroke severity.
Conclusion: The MAPH score is a simple and practical tool that aids in distinguishing AIS from TIA and predicting major vessel occlusion, thus improving stroke management in emergency settings.

Keywords

MAPH score , acute ischemic stroke , transient ischemic attack , major vessel occlusion , emergency medicine

Ethical Statement

This study was approved by the Ethics Committee of the Ministry of Health Ankara Etlik City Hospital, Ankara, TURKEY (Date: 25/09/2024, Decision No: AEŞH-BADEK-2024-893).

Supporting Institution

None

Project Number

None

Thanks

None

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