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The Usage of Hemogram Parameters for Determining High Centor Score

Year 2022, Volume: 44 Issue: 3, 398 - 404, 14.03.2022
https://doi.org/10.20515/otd.1005296

Abstract

Modified Centor Criteria are frequently used to differantiate bacterial-viral tonsilopharyngitis. This scoring system is based on subjective data such as history and physical examination. In this study, the use of hemogram parameters in determining high centor score was investigated. Patients who applied to otolaryngology outpatient clinic with complaint of sore throat between 01/01/2019-31/12/2019 and were diagnosed with acute tonsilopharyngitis were retrospectively scanned. Of these patients, those who were requested to have hemogram at their admission were included in study. Modified centor score was calculated by examining recorded anamnesis and physical examination. Those with a centor score of 4 formed high centor group, while those with a centor score 0 and 1 formed low centor group. It was ensured that there were 30 patients in each group. Two groups were compared in terms of hemogram parameters. Mean white blood cell, neutrophil and monocyte counts were higher in high centor group (10.96±3.49, 7.91±3.43, 1.06±0.34, respectively) than in low centor group (7.94±2.11, 5.10±1.94, 0.66±0.23, respectively). These differences are statistically significant (p<0.001, p<0.001, p<0.001, respectively). Mean MCV and MPV values found in high centor group (84.17±5.48, 9.44±0.99, respectively) were lower than values found in low centor group (86.89±4.49, 10.14±0.78, respectively). These differences are also statistically significant (p=0.008, p= 0.004, respectively). In addition, mean RDW value was found to be higher in high centor group (13.88±1.44) than in low centor group (13.06±0.92, p=0.012). When calculated data were analyzed, mean neutrophil-lymphocyte and monocyte-lymphocyte ratios were found to be higher in high centor group (5.25±4.41, 0.62±0.21, respectively) than in low centor group(3.17±3.04, 0.39±0.24, p<0.001, p<0.001, respectively). Hemogram parameters can be used both to determine high centor score and to differentiate bacterial and viral etiology in acute tonsilopharyngitis. Usage of hemogram parameters together with modified centor scoring system can increase sensitivity and specificity of this scoring system.

References

  • 1-Cag Y, Özdemir AA, Yükselmiş U et al. Association between rapid antigen testing and antibiotic use and accuracy of peripheral blood parameters in detecting group a streptococcus in children with tonsillopharyngitis. Frontiers In Pediatrics. 2019;7:322.
  • 2-Schwartz B, Marcy SM, Phillips WR et al. Pharyngitis—principles of judicious use of antimicrobial agents. Pediatrics. 1998;101(Supplement 1):171-174.
  • 3-McIsaac WJ, Kellner JD, Aufricht P et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. Jama. 2004;291(13):1587-1595.
  • 4-Stefaniuk E, Bosacka K, Wanke-Rytt M et al. The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. European Journal of Clinical Microbiology & Infectious Diseases. 2017;36(10):1733-1738.
  • 5-Saengcharoen W, Jaisawang P, Udomcharoensab P et al. Appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria. International Journal of Clinical Pharmacy. 2016;38(5):1318-1325.
  • 6-Acar T, Ertekin B, Girisgin AS et al. Efficiency of rapid antigen test in diagnosis of acute streptococcal tonsillopharyngitis. Clinical and Experimental Health Sciences. 2019;9(3):241-245.
  • 7-Lindgren C, Neuman MI, Monuteaux MC et al. Patient and parent-reported signs and symptoms for group A Streptococcal pharyngitis. Pediatrics. 2016;138(1):e20160317
  • 8-Harris AM, Hicks LA, Qaseem A. Appropriate antibiotic use for acute respiratory tract ınfection in adults. Ann Intern Med. 2016;165(9):674.
  • 9-Snow V, Mottur-Pilson C, Cooper RJ et al. Principles of appropriate antibiotic use for acute pharyngitis in adults. Annals of Internal Medicine. 2001;134(6):506-508.
  • 10-Patel C, Green BD, Batt JM et al. Antibiotic prescribing for tonsillopharyngitis in a general practice setting. Aust J Gen Pract. 2019;48(6):395-401.
  • 11-Roggen I, van Berlaer G, Gordts F et al. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ open. 2013;3(4):e002712.
  • 12-Centor RM, Witherspoon JM, Dalton HP et al. The diagnosis of strep throat in adults in the emergency room. Medical Decision Making. 1981;1(3):239-246.
  • 13-McIsaac WJ, White D, Tannenbaum D et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. Cmaj. 1998;158(1):75-83.
  • 14-Aalbers J, O'Brien KK, Chan WS et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC medicine. 2011;9(1):1-11.
  • 15-Shaikh N, Swaminathan N, Hooper EG. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. The Journal of Pediatrics. 2012;160(3):487-493.

Yüksek Centor Skorunu Belirlemede Hemogram Parametrelerinin Kullanımı

Year 2022, Volume: 44 Issue: 3, 398 - 404, 14.03.2022
https://doi.org/10.20515/otd.1005296

Abstract

Modifiye Centor Kriterleri bakteriyel-viral tonsilofaranjit ayrımında sıklıkla kullanılmaktadır. Bu puanlama sistemi anamnez ve fizik muayene bulguları gibi subjektif verilere dayanmaktadır. Bu çalışmada yüksek centor skorunu belirlemede hemogram parametrelerinin kullanımı araştırılmıştır. 01/01/2019-31/12/2019 tarihleri arasında boğaz ağrısı şikayeti ile kulak burun boğaz polikliniğine başvurmuş ve akut tonsilofaranjit tanısı alan hastalar retrospektif olarak tarandı. Bu hastalardan bu başvurularında hemogram tetkiki istenmiş olanlar çalışmaya dahil edildi. Tüm hastaların kayıtlı anamnez ve fizik muayene bulguları incelenerek modifiye centor skoru hesaplandı. Centor skoru 4 olanlar yüksek centor grubunu oluştururken, centor skoru 0 ve 1 olanlar düşük centor grubunu oluşturdu. Herbir grupta 30 hastanın olması sağlandı. İki grup hemogram parametreleri açısından karşılaştırıldı. Ortalama beyaz küre sayısı, nötrofil sayısı, monosit sayısı yüksek centor grubunda (10.96±3.49, 7.91±3.43, 1.06±0.34, sırasıyla) düşük centor grubundan (7.94±2.11, 5.10±1.94, 0.66±0.23, sırasıyla) daha yüksek saptanmıştır. Bu farklar istatistiksel olarak anlamlıdır (p<0.001, p<0.001, p<0.001,sırasıyla). Yüksek centor grubunda saptanan ortalama MCV ve MPV değerleri (84.17±5.48, 9.44±0.99, sırasıyla) düşük centor grubunda saptanan değerlerden (86.89±4.49, 10.14±0.78, sırasıyla) daha düşüktür. Bu farklar da istatistiksel olarak anlamlıdır (p=0.008, p= 0.004, sırasıyla). Ayrıca ortalama RDW değeri yüksek centor grubunda (13.88±1.44) düşük centor grubuna göre (13.06±0.92) daha yüksek bulunmuştur (p=0.012). Hesaplanan veriler incelendiğinde ortalama nötrofil-lenfosit oranı ve ortalama monosit-lenfosit oranı yüksek centor grubunda (5.25±4.41, 0.62±0.21, sırasıyla) düşük centor grubuna göre (3.17±3.04, 0.39±0.24, sırasıyla) daha yüksek saptanmıştır (p<0.001, p<0.001, sırasıyla). Hemogram parametreleri hem yüksek centor skorunu belirlemede hem de akut tonsilofaranjit etiyolojisinde bakteriyel-viral ayrımını yapmakta kullanılabilir. Hemogram parametrelerinin modifiye centor puanlama sistemiyle birlikte kullanımı bu puanlama sisteminin duyarlılık ve özgüllüğünü arttırabilir.

References

  • 1-Cag Y, Özdemir AA, Yükselmiş U et al. Association between rapid antigen testing and antibiotic use and accuracy of peripheral blood parameters in detecting group a streptococcus in children with tonsillopharyngitis. Frontiers In Pediatrics. 2019;7:322.
  • 2-Schwartz B, Marcy SM, Phillips WR et al. Pharyngitis—principles of judicious use of antimicrobial agents. Pediatrics. 1998;101(Supplement 1):171-174.
  • 3-McIsaac WJ, Kellner JD, Aufricht P et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. Jama. 2004;291(13):1587-1595.
  • 4-Stefaniuk E, Bosacka K, Wanke-Rytt M et al. The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. European Journal of Clinical Microbiology & Infectious Diseases. 2017;36(10):1733-1738.
  • 5-Saengcharoen W, Jaisawang P, Udomcharoensab P et al. Appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria. International Journal of Clinical Pharmacy. 2016;38(5):1318-1325.
  • 6-Acar T, Ertekin B, Girisgin AS et al. Efficiency of rapid antigen test in diagnosis of acute streptococcal tonsillopharyngitis. Clinical and Experimental Health Sciences. 2019;9(3):241-245.
  • 7-Lindgren C, Neuman MI, Monuteaux MC et al. Patient and parent-reported signs and symptoms for group A Streptococcal pharyngitis. Pediatrics. 2016;138(1):e20160317
  • 8-Harris AM, Hicks LA, Qaseem A. Appropriate antibiotic use for acute respiratory tract ınfection in adults. Ann Intern Med. 2016;165(9):674.
  • 9-Snow V, Mottur-Pilson C, Cooper RJ et al. Principles of appropriate antibiotic use for acute pharyngitis in adults. Annals of Internal Medicine. 2001;134(6):506-508.
  • 10-Patel C, Green BD, Batt JM et al. Antibiotic prescribing for tonsillopharyngitis in a general practice setting. Aust J Gen Pract. 2019;48(6):395-401.
  • 11-Roggen I, van Berlaer G, Gordts F et al. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ open. 2013;3(4):e002712.
  • 12-Centor RM, Witherspoon JM, Dalton HP et al. The diagnosis of strep throat in adults in the emergency room. Medical Decision Making. 1981;1(3):239-246.
  • 13-McIsaac WJ, White D, Tannenbaum D et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. Cmaj. 1998;158(1):75-83.
  • 14-Aalbers J, O'Brien KK, Chan WS et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC medicine. 2011;9(1):1-11.
  • 15-Shaikh N, Swaminathan N, Hooper EG. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. The Journal of Pediatrics. 2012;160(3):487-493.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Ceyhun Cengiz 0000-0002-5177-2540

Publication Date March 14, 2022
Published in Issue Year 2022 Volume: 44 Issue: 3

Cite

Vancouver Cengiz C. Yüksek Centor Skorunu Belirlemede Hemogram Parametrelerinin Kullanımı. Osmangazi Tıp Dergisi. 2022;44(3):398-404.


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