The Role of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as A Prognostic Factor in Diabetic Patients in Intensive Care

Abstract

Objective: Neutrophil lymphocyte ratio and platelet lymphocyte ratio are used to determine the prognosis of some diseases. In this study, it was aimed to determine the reliability of neutrophil lymphocyte ratio and platelet lymphocyte ratio, as a method in determining the 28-day mortality of diabetic patients followed in intensive care, and its correlation with APACHE II, SOFA, and MPM scores.

Material and Methods: Eighty diabetic patients who were followed up in intensive care unit in 2018 and 2019 were enrolled. Patients who survived 28 days were defined as Group 1, and patients who died within 28 days were defined as Group 2. The main neutrophil lymphocyte ratio, platelet lymphocyte ratio, APACHE II and MPM values of the patients in the two groups were used in the study.

Results: There was no difference between the groups in terms of 0, 48 and 72 hour neutrophil lymphocyte ratio values (p=0.111;0.061;0.071, respectively). However, neutrophil lymphocyte ratio values were lower in Group 1. There was no difference between the groups in terms of platelet lymphocyte ratios at 0, 48 and 72 hours. However, the platelet lymphocyte ratio value in Group 2 was peaking at the 48th hour. The APACHE II and MPM scores of Group NS in the three time frames were statistically significantly higher. Spearman's rho correlation test showed that there was a correlation between neutrophil lymphocyte ratio values and APACHE II (p=0.415) and MPM (p=0.176) scores in the first day of 80 patients. Also platelet lymphocyte ratio values and APACHE II (p=0.549) and MPM (p=0.896) scores on the first day of 80 patients were correlated.

Conclusion: Neutrophil lymphocyte ratio and platelet lymphocyte ratio values can be considered as an important marker in determining 28-day mortality in diabetic patients admitted to the intensive care unit.

Keywords

• Intensive care
• diabetes mellitus
• mortality scoring
• neutrophil lymphocyte ratio
• platelet lymphocyte ratio

YOĞUN BAKIMDA DİYABETİK HASTALARDA PROGNOSTİK BİR FAKTÖR OLARAK NÖTROFİL-LENFOSİT VE PLATELET-LENFOSİT ORANLARININ ROLÜ

Abstract

Amaç: Nötrofil lenfosit oranı ve platelet lenfosit oranı bazı hastalıkların prognozunun takibinde uygulanmaktadır. Bu çalışmada yoğun bakımda takip edilen diyabetik hastalarının 28 günlük mortalite oranının belirlenmesinde nötrofil lenfosit oranı ve platelet lenfosit oranı değerlerinin etkinliğinin tespiti amaçlandı ve ayrıca nötrofil lenfosit oranı ve platelet lenfosit oranı ile APACHE II, SOFA, MPM skorları arasındaki korelasyon araştırıldı.

Gereç ve Yöntemler: 2018 ve 2019 yıllarında 3. basamak yoğun bakım ünitesinde takip edilen 80 diyabetik hasta dahil edildi. Yirmi sekiz gün hayatta kalan hastalar Grup 1, 28 gün içinde hayatını kaybeden hastalar Grup 2 olarak tanımlandı. İki grupta yer alan hastaların başlıca nötrofil lenfosit oranı, platelet lenfosit oranı, APACHE II ve MPM değerleri çalışmada kullanıldı.

Bulgular: Gruplar arasında 0., 48. ve 72. saat nötrofil lenfosit oranı değerleri açısından fark yoktu (sırasıyla p=0.111; 0.061; 0.071). Ancak Grup 1’de nötrofil lenfosit oranı değerleri daha düşüktü. Platelet Lenfosit Oranları açısından 0., 48. ve 72. saatlerde gruplar arasında fark tespit edilmedi. Ancak 48. saatte Grup 2’de platelet lenfosit oranı değerinin pik yaptığı saptandı. İki grup APACHE II ve MPM skorları açısından karşılaştırıldığın da üç zaman diliminde Grup 2’nin APACHE II ve MPM skorları istatistiksel olarak anlamlı fark olacak şekilde daha yüksekti. Spearman's rho korolasyon testi ile yapılan değerlendirmede: toplam 80 hastanın ilk gün hesaplanan nötrofil lenfosit oranı değerleri ile APACHE II (p=0.415) ve MPM (p=0.176) skorları arasında ve yine 80 hastanın ilk gün platelet lenfosit oranı değerleri ile APACH II (p=0.549) ve MPM (p=0.896) skorları arasında korelasyon bulundu.

Sonuç: Nötrofil lenfosit oranı ve platelet lenfosit oranı değerleri, yoğun bakım ünitesine kabul edilen diyabetik hastalarda 28 günlük mortalitenin belirlenmesinde önemli bir belirteç olarak düşünülebilir.

Keywords

• diyabetes mellitus
• yoğun bakım
• mortalite skorlamaları
• nötrofil lenfosit oranı
• platelet lenfosit oranı

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