Clinical Research
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Determination of the effects of inflammatory markers on mortality in intensive care patients

Year 2022, Volume: 5 Issue: 3, 389 - 396, 31.12.2022
https://doi.org/10.36516/jocass.1187288

Abstract

Abstract
Aim: Mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW) plays important role as effective factors in predicting mortality and morbidity in various diseases. In the present study we aimed to assess and compare MPV, NLR, PLR and RDW of survived and non-survived patients by examining the blood samples taken within the first hour after admission to our intensive care unit.
Methods: This retrospective study included 672 patients who were hospitalized in a mixed 16 bed intensive care unit (ICU) between January 2019 and January 2020. By examining our hospital's computer-based data system, patient data of the survived and non-survived patients who were treated in the ICU were analyzed.
Results: The demographic parameters of the patients (gender), concomitant disease, and laboratory parameters including HTC, PLT, WBC, MPV and PLR were not significantly different between the survived and non-survived patients. RDW, albumin, CRP and NLR were found statistically different between the study groups.
Conclusions: The elevated RDW, NLR and CRP levels were found more significant than the other inflammatory markers for determining mortality of the critically ill patients. In addition, evaluation of albumin level was found important in defining the prognosis of the intensive care unit patients.

References

  • 1) Pilling LC, Atkins JL, Kuchel GA et al. PLoS One.2008;13(9):e0203504.
  • 2) Salvagno GL, Sanchis-Gomar F, Picanza A et al. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci.2015;52:86-105.
  • 3) Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: a systematic review and meta-analysis. Platelets.2016;27:722-728.
  • 4) Chu SG, Becker RC,Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb. Haemost. 2010;8:148-156.
  • 5) Shen J, Ran ZH, Zhang Y, et al. Biomarkers of altered coagulation and fibrinolysis as measures of disease activity in active inflammatory bowel disease: a gender-stratified cohort analysis. Thromb Res. 2009;123:604-611.
  • 6) Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets.2010;21:122-125.
  • 7) Sarraf KM, Belcher E, Raevsky E, et al. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg. 2009;137:425-8.
  • 8) Cho H, Hur H, Kim S, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58:15-23.
  • 9) Azab B, Bhatt VR, Phookan J, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting short and long term mortality in breast cancer patients. Ann Surg Oncol. 2012;19:217-24.
  • 10) Sarı R, Karakurt Z, Ay M, et al. Neutrophil to lymphocyte ratio as a predictor of treatment response and mortality in septic shock patients in the intensive care unit. Turkish J. Med. Sci. 2019;49(5):1336–1349. doi: 10.3906/sag-1901-105
  • 11) Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11(1):55–59. doi: 10.1586/erc.12.159.
  • 12) Jilma B, Blann A, Pernerstorfer T, et al. Regulation of adhesion molecules during human endotoxemia. No acute effects of aspirin. Am J Respir Crit Care Med. 1999;159:857–863. doi: 10.1164/ajrccm.159.3.9805087
  • 13) Akilli NB, Yortanlı M, Mutlu H, et al. Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes. Am J Emerg Med. 2014;32:1476–80.
  • 14) Lionte C, Bologa C, Sorodoc V et al. Biomarkers of inflammation and inflammation-related indexes upon emergency department admission are predictive for the risk of intensive care unit hospitalization and mortality in acute poisoning; a 6year prospective observational study. Disease markers 2021, Article ID 4696156. https://doi.org/10.1155/2021/4696156. 15) Akcal MA, Eke I. Post-operative red cell distribution width increase may predict mortality in patients operated for hip fracture. Clin Lab. 2021Nov1;67(11). doi:10.7754/Clin.Lab.2021.2021.210337.
  • 16) Ham SY, Yoon HJ, Nam SB, et al. Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/ platelet ratio for one 1-year mortality in critically ill patients. Scientific reports. 2020;10:21513. 17) Zhai G, Wang J, Liu Y, et al. Platelet-lymphocyte ratio as a new predictor of in-hospital mortality in cardiac intensive care unit patients. Sci Rep. 2021; 11: 23578.
  • 18) Kaito K, Otsubo H, Usui N, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haemotol 2005;128(5)698-702.
  • 19) Zhang Z, Xu X, Ni H, et al. Platelet indices are novel predictors of hospital mortality in intensive care units. Journal of Critical Care. 2014;29:885.e1-885.e6
  • 20) Wang R, Jin D, Li Y, et al. Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer’s disease. Journal of Psychiatric Research. 2013; 47:644-649.
  • 21) Boos CJ, Beevers GD, Lip GY. Assessment of platelet activation indices using the ADVIATM 120 amongst ‘high-risk’ patients with hypertension. Annals of Medicine 2007;39:72e8.
  • 22) Jagroop IA, Mikhailidis DP. Angiotensin II can induce and potentiate shape change in human platelets: effect of losartan. Journal of Human Hypertension 2000;14: 581e5
  • 23) Onal O, Ozgun G. Comparison of the course and prognosis of geriatric patients admitted to the intensive care unit according to BMI and albumin values. Anesth Pain Med. 2016;6(1):e32509.
  • 24) Yildiz A, Yigit A, Benli A. The impact of nutritional status and complete blood count parameters on clinical outcome in geriatric critically ill patients. J Clin Med Res. 2018;10(7):588-592.
  • 25) Ho KM, Lee KY, Dobb GJ, et al. C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: A prospective cohort study. Intensive Care Med. 2008;34(3):481-487.
  • 26) Litton E, Ho KM, Chamberlain J, et al. C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: a nested case-control study. Crit Care Resusc. 2007;9(1):19-25.

YOĞUN BAKIM HASTALARINDA İNFLAMATUAR BELİRTEÇLERİN MORTALİTE ÜZERİNE ETKİLERİNİN BELİRLENMESİ

Year 2022, Volume: 5 Issue: 3, 389 - 396, 31.12.2022
https://doi.org/10.36516/jocass.1187288

Abstract

Amaç: Ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı (NLR), trombosit/lenfosit oranı (PLR), kırmızı hücre dağılım genişliği (RDW), çeşitli hastalıklarda mortalite ve morbiditeyi öngörmede etkili faktörler olarak önemli rol oynamaktadır. Bu çalışmada, yoğun bakım ünitemize kabul edildikten sonraki ilk saat içinde alınan kan örneklerini inceleyerek sağ kalan ve yaşamayan hastaların MPV, NLR, PLR ve RDW'sini değerlendirmeyi ve karşılaştırmayı amaçladık.
Materyal ve Metodlar: Bu retrospektif çalışmaya Ocak 2019-Ocak 2020 tarihleri arasında 16 yataklı karma yoğun bakım ünitesinde yatan 672 hasta dahil edildi. Hastanemizin bilgisayar tabanlı veri sistemi incelenerek yoğun bakım ünitesinde tedavi gören hayatta kalan ve hayatta kalmayan hastaların hasta verileri değerlendirildi.
Sonuç: Hastaların demografik parametreleri (cinsiyet), eşlik eden hastalık ve Htc, PLT, WBC, MPV ve PLR dahil laboratuvar parametreleri, hayatta kalan ve hayatta kalmayan hastalar arasında önemli ölçüde farklı değildi. RDW, albümin, CRP ve NLR çalışma grupları arasında istatistiksel olarak farklı bulundu.
Tartışma: Kritik hastalarda mortaliteyi belirlemede yüksek RDW, NLR ve CRP seviyeleri diğer inflamatuar belirteçlerden daha anlamlı bulundu. Ayrıca yoğun bakım hastalarının prognozunu belirlemede albümin düzeyinin değerlendirilmesi önemli bulundu.

References

  • 1) Pilling LC, Atkins JL, Kuchel GA et al. PLoS One.2008;13(9):e0203504.
  • 2) Salvagno GL, Sanchis-Gomar F, Picanza A et al. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci.2015;52:86-105.
  • 3) Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: a systematic review and meta-analysis. Platelets.2016;27:722-728.
  • 4) Chu SG, Becker RC,Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb. Haemost. 2010;8:148-156.
  • 5) Shen J, Ran ZH, Zhang Y, et al. Biomarkers of altered coagulation and fibrinolysis as measures of disease activity in active inflammatory bowel disease: a gender-stratified cohort analysis. Thromb Res. 2009;123:604-611.
  • 6) Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets.2010;21:122-125.
  • 7) Sarraf KM, Belcher E, Raevsky E, et al. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg. 2009;137:425-8.
  • 8) Cho H, Hur H, Kim S, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58:15-23.
  • 9) Azab B, Bhatt VR, Phookan J, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting short and long term mortality in breast cancer patients. Ann Surg Oncol. 2012;19:217-24.
  • 10) Sarı R, Karakurt Z, Ay M, et al. Neutrophil to lymphocyte ratio as a predictor of treatment response and mortality in septic shock patients in the intensive care unit. Turkish J. Med. Sci. 2019;49(5):1336–1349. doi: 10.3906/sag-1901-105
  • 11) Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11(1):55–59. doi: 10.1586/erc.12.159.
  • 12) Jilma B, Blann A, Pernerstorfer T, et al. Regulation of adhesion molecules during human endotoxemia. No acute effects of aspirin. Am J Respir Crit Care Med. 1999;159:857–863. doi: 10.1164/ajrccm.159.3.9805087
  • 13) Akilli NB, Yortanlı M, Mutlu H, et al. Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes. Am J Emerg Med. 2014;32:1476–80.
  • 14) Lionte C, Bologa C, Sorodoc V et al. Biomarkers of inflammation and inflammation-related indexes upon emergency department admission are predictive for the risk of intensive care unit hospitalization and mortality in acute poisoning; a 6year prospective observational study. Disease markers 2021, Article ID 4696156. https://doi.org/10.1155/2021/4696156. 15) Akcal MA, Eke I. Post-operative red cell distribution width increase may predict mortality in patients operated for hip fracture. Clin Lab. 2021Nov1;67(11). doi:10.7754/Clin.Lab.2021.2021.210337.
  • 16) Ham SY, Yoon HJ, Nam SB, et al. Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/ platelet ratio for one 1-year mortality in critically ill patients. Scientific reports. 2020;10:21513. 17) Zhai G, Wang J, Liu Y, et al. Platelet-lymphocyte ratio as a new predictor of in-hospital mortality in cardiac intensive care unit patients. Sci Rep. 2021; 11: 23578.
  • 18) Kaito K, Otsubo H, Usui N, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haemotol 2005;128(5)698-702.
  • 19) Zhang Z, Xu X, Ni H, et al. Platelet indices are novel predictors of hospital mortality in intensive care units. Journal of Critical Care. 2014;29:885.e1-885.e6
  • 20) Wang R, Jin D, Li Y, et al. Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer’s disease. Journal of Psychiatric Research. 2013; 47:644-649.
  • 21) Boos CJ, Beevers GD, Lip GY. Assessment of platelet activation indices using the ADVIATM 120 amongst ‘high-risk’ patients with hypertension. Annals of Medicine 2007;39:72e8.
  • 22) Jagroop IA, Mikhailidis DP. Angiotensin II can induce and potentiate shape change in human platelets: effect of losartan. Journal of Human Hypertension 2000;14: 581e5
  • 23) Onal O, Ozgun G. Comparison of the course and prognosis of geriatric patients admitted to the intensive care unit according to BMI and albumin values. Anesth Pain Med. 2016;6(1):e32509.
  • 24) Yildiz A, Yigit A, Benli A. The impact of nutritional status and complete blood count parameters on clinical outcome in geriatric critically ill patients. J Clin Med Res. 2018;10(7):588-592.
  • 25) Ho KM, Lee KY, Dobb GJ, et al. C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: A prospective cohort study. Intensive Care Med. 2008;34(3):481-487.
  • 26) Litton E, Ho KM, Chamberlain J, et al. C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: a nested case-control study. Crit Care Resusc. 2007;9(1):19-25.
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences, Anaesthesiology, Intensive Care
Journal Section Articles
Authors

Tevfik Honca 0000-0003-3723-1374

Ayşegül Parlak 0000-0001-5684-5975

Hakan Öz 0000-0003-3551-5306

Ebru Sarer 0000-0003-0185-7973

Mehtap Honca 0000-0003-1779-249X

Publication Date December 31, 2022
Acceptance Date December 26, 2022
Published in Issue Year 2022 Volume: 5 Issue: 3

Cite

APA Honca, T., Parlak, A., Öz, H., Sarer, E., et al. (2022). Determination of the effects of inflammatory markers on mortality in intensive care patients. Journal of Cukurova Anesthesia and Surgical Sciences, 5(3), 389-396. https://doi.org/10.36516/jocass.1187288

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