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Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers

Year 2020, Volume: 4 Issue: 7, 578 - 581, 01.07.2020
https://doi.org/10.28982/josam.739227

Abstract

Aim: Inflammation may have deleterious effects on tissue healing. Pressure ulcers impair the quality of life of the patients admitted to intensive care unit (ICU) besides increasing the health costs. Neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are simple and readily available markers proinflammatory state. This study aimed to investigate whether measurement of admission NLR and MPV could be useful in identification of the patients who are at elevated risk for the development of the pressure ulcers.
Methods: This retrospective cohort study evaluated 104 patients admitted to the intensive care unit of a tertiary center. Patients were divided into two groups according to the presence of pressure ulcers as follows: Patients without pressure ulcers throughout hospitalization and patients who developed pressure ulcers while hospitalized. The two groups were compared with respect to the demographic features and complete blood count parameters at admission.
Results: The NLR [8.8 (6.6) vs. 5.3 (2.6), P<0.001], platelet to lymphocyte ratio [322(125) vs. 234(116), P=0.023] and MPV [10.5 (1.5) fl vs. 9.8 (1.1) fl, P<0.001] were significantly higher, and length of ICU stay was significantly longer in patients with pressure ulcers than those without [16.1 (3.8) days vs. 12.5 (2.9) days, P<0.001]. Logistic regression analysis revealed that age (P=0.03), length of ICU stay (P=0.01), NLR (P=0.01) and MPV (P=0.01) were significantly predictive for the presence of pressure ulcers.
Conclusions: Our findings indicate that age, length of ICU stay, and NLR, and MPV, which are indicative for the preexisting inflammatory state, are independent predictors for the development of pressure ulcers in patients admitted to the ICU

References

  • 1. McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database of Syst Rev. 2015:Cd001735.
  • 2. Tescher AN, Branda ME, Byrne TJ, Naessens JM. All at-risk patients are not created equal: analysis of Braden pressure ulcer risk scores to identify specific risks. J Wound Ostomy Continence Nurs. 2012;39:282-91.
  • 3. Kaya BB. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. 2019;3(7):512-4.
  • 4. Magri CJ, Tian TX, Camilleri L, Xuereb R, Galea J, Fava S. Red blood cell distribution width and myocardial scar burden in coronary artery disease. Postgrad Med J. 2017;93:607-12.
  • 5. Maruyama Y, Inoue K, Mori K, Gorai K, Shimamoto R, Onitsuka T, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol. 2017;137:106-10.
  • 6. Serbest S, Tiftikci U, Tosun HB, Gumustas SA, Uludag A. Is there a relationship between fracture healing and mean platelet volume? Ther Clin Risk Manag. 2016;12:1095-9.
  • 7. Demarre L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J, et al. The cost of prevention and treatment of pressure ulcers: A systematic review. Int J Nurs Stud. 2015;52:1754-74.
  • 8. Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. J Clin Nurs. 2010;19:414-21.
  • 9. Jiang Q, Li X, Qu X, Liu Y, Zhang L, Su C, et al. The incidence, risk factors and characteristics of pressure ulcers in hospitalized patients in China. Int J Clin Exp Pathol. 2014;7:2587-94.
  • 10. Collier M. Pressure ulcer prevention: fundamentals for best practice. Acta Medica Croatica: 2016;70 Suppl 1:3-10.
  • 11. Lumbers M. Pressure ulcers: an overview of risk. Br J Nurs. 2017;26:S49-S50.
  • 12. Spruce L. Back to Basics: Preventing Perioperative Pressure Injuries. AORN J. 2017;105:92-9.
  • 13. Blenman J, Marks-Maran D. Pressure ulcer prevention is everyone's business: the PUPS project. Br J Nurs. 2017;26:S16-S26.
  • 14. Sving E, Fredriksson L, Gunningberg L, Mamhidir AG. Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting. J Clin Nurs. 2017;26:3200-11.
  • 15. Cullum N, Deeks JJ, Fletcher AW, Sheldon TA, Song F. Preventing and treating pressure sores. Qual Health Care.1995;4:289-97.
  • 16. Lima-Serrano M, Gonzalez-Mendez MI, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Med Intensiva. 2018;42:82-91.
  • 17. Gonzalez-Mendez MI, Lima-Serrano M, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27:1028-37.
  • 18. Lima S, Gonzalez M, Carrasco C, Lima R. Risk factors for pressure ulcer development in Intensive Care Units: A systematic review. Med Intensiva. 2017;41:339-46.
  • 19. Borsting TE, Tvedt CR, Skogestad IJ, Granheim TI, Gay CL, Lerdal A. Prevalence of pressure ulcer and associated risk factors in middle- and older-aged medical inpatients in Norway. J Clin Nurs. 2018;27:e535-e43.
  • 20. Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, et al. Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013;50:974-1003.
  • 21. Zhou Q, Yu T, Liu Y, Shi R, Tian S, Yang C, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs.2018;27:694-704.
  • 22. Garraud O, Hamzeh-Cognasse H, Pozzetto B, Cavaillon JM, Cognasse F. Bench-to-bedside review: Platelets and active immune functions - new clues for immunopathology? Crit Care. 2013;17:236.
  • 23. Fernandez-Moure JS, Van Eps JL, Cabrera FJ, Barbosa Z, Medrano Del Rosal G, Weiner BK, et al. Platelet-rich plasma: a biomimetic approach to enhancement of surgical wound healing. Journal Surg Res. 2017;207:33-44.
  • 24. Yıldırım ÖT, Akşit E, Aydın F, Aydın AH, Dağtekin E. Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure? J Surg Med. 2019;3(1):4-7.
  • 25. Uysal P, Tuncel T, Olmez D, Babayigit A, Karaman O, Uzuner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227- 30.
  • 26. Yuksel O, Helvaci K, Basar O, Koklu S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20:277-81.
  • 27. Yazici S, Yazici M, Erer B, Erer B, Calik Y, Ozhan H, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122-5.
  • 28. Akça A, Yılmaz G, Köroğlu N. Platelet Indices as the Predictor of Antibiotics Response in Surgical Wound Infections Following Total Abdominal Hysterectomy. Sisli Etfal Hast Tip Bul. 2019;53:132-6.
  • 29. Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016;22:405-11.
  • 30. Dong CH, Wang ZM, Chen SY. Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis. Clin Biochem. 2018;52:131-6.
  • 31. Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10:12.

Nötrofil lenfosit oranı ve ortalama trombosit hacmi bası yarası oluşumu öngörebilir

Year 2020, Volume: 4 Issue: 7, 578 - 581, 01.07.2020
https://doi.org/10.28982/josam.739227

Abstract

Amaç: İnflamasyonun doku iyileşmesi üzerinde olumsuz etkileri olabilir. Basınç ülserleri, yoğun bakım ünitesine (YBÜ) kabul edilen hastaların yaşam kalitesini bozmanın yanı sıra sağlık maliyetlerini de arttırır. Nötrofil/lenfosit oranı (NLR) ve ortalama trombosit hacmi (MPV) basit ve kolayca temin edilebilen proinflamatuar belirteçlerdir. Bu çalışma, NLR ve MPV giriş ölçümünün, basınç ülserlerinin gelişimi için yüksek risk altında olan hastaların tanımlanmasında faydalı olup olmadığını araştırmayı amaçlamıştır.
Yöntemler: Bu retrospektif kohort çalışması ile üçüncü basamak bir merkezin yoğun bakım ünitesine başvuran 104 hastanın değerlendirilmesi yapıldı. Basınç ülseri varlığına göre hastalar şu şekilde iki gruba ayrıldı: Hastanede yatış boyunca basınç ülseri olmayan hastalar ve hastanede yatış döneminde basınç ülseri gelişen hastalar. İki grup demografik özellikler ve geliş tam kan sayımı parametreleri açısından karşılaştırıldı.
Bulgular: NLR [8,8 (6,6) / 5,3 (2,6), P<0,001], trombosit-lenfosit oranı [322 (125) / 234 (116), P=0,023] ve MPV [10,5 (1,5) fl / 9,8 (1,1) fl, P<0,001] basınç ülseri olan hastalarda olmayanlara göre anlamlı olarak daha yüksekti. YBÜ'de kalış süresi de basınç ülseri olanlarda basınç ülseri olmayanlardan anlamlı olarak daha uzundu [16,1 (3,8) güne karşı 12.5 (2,9) gün, P<0.001]. Lojistik regresyon analizi yaş (P=0.03), YBÜ kalış süresi (P=0,01), NLR (P=0,01) ve MPV'nin (P=0,01) basınç ülserlerinin varlığı için anlamlı olduğunu göstermiştir.
Sonuçlar: Bulgularımız, önceden var olan enflamatuar durumu gösteren yaş, YBÜ kalış süresi ve NLR ve MPV'nin YBÜ'ye kabul edilen hastalarda basınç ülseri gelişimi için bağımsız belirteçler olduğunu göstermektedir

References

  • 1. McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database of Syst Rev. 2015:Cd001735.
  • 2. Tescher AN, Branda ME, Byrne TJ, Naessens JM. All at-risk patients are not created equal: analysis of Braden pressure ulcer risk scores to identify specific risks. J Wound Ostomy Continence Nurs. 2012;39:282-91.
  • 3. Kaya BB. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. 2019;3(7):512-4.
  • 4. Magri CJ, Tian TX, Camilleri L, Xuereb R, Galea J, Fava S. Red blood cell distribution width and myocardial scar burden in coronary artery disease. Postgrad Med J. 2017;93:607-12.
  • 5. Maruyama Y, Inoue K, Mori K, Gorai K, Shimamoto R, Onitsuka T, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol. 2017;137:106-10.
  • 6. Serbest S, Tiftikci U, Tosun HB, Gumustas SA, Uludag A. Is there a relationship between fracture healing and mean platelet volume? Ther Clin Risk Manag. 2016;12:1095-9.
  • 7. Demarre L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J, et al. The cost of prevention and treatment of pressure ulcers: A systematic review. Int J Nurs Stud. 2015;52:1754-74.
  • 8. Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. J Clin Nurs. 2010;19:414-21.
  • 9. Jiang Q, Li X, Qu X, Liu Y, Zhang L, Su C, et al. The incidence, risk factors and characteristics of pressure ulcers in hospitalized patients in China. Int J Clin Exp Pathol. 2014;7:2587-94.
  • 10. Collier M. Pressure ulcer prevention: fundamentals for best practice. Acta Medica Croatica: 2016;70 Suppl 1:3-10.
  • 11. Lumbers M. Pressure ulcers: an overview of risk. Br J Nurs. 2017;26:S49-S50.
  • 12. Spruce L. Back to Basics: Preventing Perioperative Pressure Injuries. AORN J. 2017;105:92-9.
  • 13. Blenman J, Marks-Maran D. Pressure ulcer prevention is everyone's business: the PUPS project. Br J Nurs. 2017;26:S16-S26.
  • 14. Sving E, Fredriksson L, Gunningberg L, Mamhidir AG. Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting. J Clin Nurs. 2017;26:3200-11.
  • 15. Cullum N, Deeks JJ, Fletcher AW, Sheldon TA, Song F. Preventing and treating pressure sores. Qual Health Care.1995;4:289-97.
  • 16. Lima-Serrano M, Gonzalez-Mendez MI, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Med Intensiva. 2018;42:82-91.
  • 17. Gonzalez-Mendez MI, Lima-Serrano M, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27:1028-37.
  • 18. Lima S, Gonzalez M, Carrasco C, Lima R. Risk factors for pressure ulcer development in Intensive Care Units: A systematic review. Med Intensiva. 2017;41:339-46.
  • 19. Borsting TE, Tvedt CR, Skogestad IJ, Granheim TI, Gay CL, Lerdal A. Prevalence of pressure ulcer and associated risk factors in middle- and older-aged medical inpatients in Norway. J Clin Nurs. 2018;27:e535-e43.
  • 20. Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, et al. Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013;50:974-1003.
  • 21. Zhou Q, Yu T, Liu Y, Shi R, Tian S, Yang C, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs.2018;27:694-704.
  • 22. Garraud O, Hamzeh-Cognasse H, Pozzetto B, Cavaillon JM, Cognasse F. Bench-to-bedside review: Platelets and active immune functions - new clues for immunopathology? Crit Care. 2013;17:236.
  • 23. Fernandez-Moure JS, Van Eps JL, Cabrera FJ, Barbosa Z, Medrano Del Rosal G, Weiner BK, et al. Platelet-rich plasma: a biomimetic approach to enhancement of surgical wound healing. Journal Surg Res. 2017;207:33-44.
  • 24. Yıldırım ÖT, Akşit E, Aydın F, Aydın AH, Dağtekin E. Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure? J Surg Med. 2019;3(1):4-7.
  • 25. Uysal P, Tuncel T, Olmez D, Babayigit A, Karaman O, Uzuner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227- 30.
  • 26. Yuksel O, Helvaci K, Basar O, Koklu S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20:277-81.
  • 27. Yazici S, Yazici M, Erer B, Erer B, Calik Y, Ozhan H, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122-5.
  • 28. Akça A, Yılmaz G, Köroğlu N. Platelet Indices as the Predictor of Antibiotics Response in Surgical Wound Infections Following Total Abdominal Hysterectomy. Sisli Etfal Hast Tip Bul. 2019;53:132-6.
  • 29. Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016;22:405-11.
  • 30. Dong CH, Wang ZM, Chen SY. Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis. Clin Biochem. 2018;52:131-6.
  • 31. Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10:12.
There are 31 citations in total.

Details

Primary Language English
Subjects Surgery, Anaesthesiology, Infectious Diseases, Orthopaedics, Medical Microbiology
Journal Section Research article
Authors

Esra Adıyeke 0000-0003-4940-1553

Levent Adıyeke 0000-0003-3014-3582

Publication Date July 1, 2020
Published in Issue Year 2020 Volume: 4 Issue: 7

Cite

APA Adıyeke, E., & Adıyeke, L. (2020). Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. Journal of Surgery and Medicine, 4(7), 578-581. https://doi.org/10.28982/josam.739227
AMA Adıyeke E, Adıyeke L. Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. J Surg Med. July 2020;4(7):578-581. doi:10.28982/josam.739227
Chicago Adıyeke, Esra, and Levent Adıyeke. “Neutrophil to Lymphocte Ratio and Mean Platelet Volume May Predict the Development of the Pressure Ulcers”. Journal of Surgery and Medicine 4, no. 7 (July 2020): 578-81. https://doi.org/10.28982/josam.739227.
EndNote Adıyeke E, Adıyeke L (July 1, 2020) Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. Journal of Surgery and Medicine 4 7 578–581.
IEEE E. Adıyeke and L. Adıyeke, “Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers”, J Surg Med, vol. 4, no. 7, pp. 578–581, 2020, doi: 10.28982/josam.739227.
ISNAD Adıyeke, Esra - Adıyeke, Levent. “Neutrophil to Lymphocte Ratio and Mean Platelet Volume May Predict the Development of the Pressure Ulcers”. Journal of Surgery and Medicine 4/7 (July 2020), 578-581. https://doi.org/10.28982/josam.739227.
JAMA Adıyeke E, Adıyeke L. Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. J Surg Med. 2020;4:578–581.
MLA Adıyeke, Esra and Levent Adıyeke. “Neutrophil to Lymphocte Ratio and Mean Platelet Volume May Predict the Development of the Pressure Ulcers”. Journal of Surgery and Medicine, vol. 4, no. 7, 2020, pp. 578-81, doi:10.28982/josam.739227.
Vancouver Adıyeke E, Adıyeke L. Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. J Surg Med. 2020;4(7):578-81.