Acil Serviste Pulmoner Tromboemboli Tanısı Konulan Hastalarda Hematolojik Parametrelerin Klinik Önemi

Abstract

ÖZET Amaç: Akut pulmoner emboli (APE), oldukça ölümcül bir akut klinik durumdur. Burada APE’nin tanı ve prognozunda kan parametrelerinin rolünü belirlemeyi amaçladık. Gereç ve Yöntem: Bu çalışma hastanemizin Acil Servisine (AS) başvuran ve APE tanısı konulan hastalar üzerinde geriye dönük olarak yapıldı. Bilgisayarlı tomografi (BT)’de RV / LV oranı 0.9’dan büyük ve hipotansiyonu olan hastalar masif APE; BT’de RV / LV oranı 0,9’dan büyük olan ve stabil hemodinamik sahip hastalar submasif APE; BT’de RV / LV oranı 0,9’dan küçük ve hemodinamisi stabil olan hastalar masif olmayan APE olarak sınıflandırıldı. Bulgular: Bu çalışmaya 82’si erkek (%41), 118’i kadın (%59) olmak üzere toplam 200 hasta alındı. Hasta ve kontrol grubunun yaş ortalaması sırasıyla 65,2 ± 17,1 ve 60,5 ± 60,5 yıldı. APE grubu, kontrol grubuna göre anlamlı olarak daha yüksek D-dimer düzeyine sahipti (3559,5±8611,3 ng/ml’ye karşı 266,6±266,6 ng/ml) (p<0,001). Troponin I düzeyleri hasta grubunda anlamlı olarak daha yüksekti (53,3±90’a karşı 332,9±32,9) (p= 0,013). Sonuç: Hematolojik parametrelerin APE alt grupları arasındaki analizi, masif APE grubunda D-Dimer, lökosit (WBC), nötrofil, lenfosit, nötrofil / lenfosit oranı (NLR) ve troponin düzeylerinin sub-masif APE ve masif olmayan APE grubuna göre anlamlı olarak daha yüksek olduğunu gösterdi.

Keywords

• Akut pulmoner emboli
• Hematolojik Parametreler
• Acil Servis.

The Clinical Importance of Hematological Parameters In Patients with Pulmonary Thromboembolism Diagnosed in The Emergency Department

Abstract

Objective: Acute pulmonary embolism (APE) is a highly fatal acute clinical condition. Herein, we aimed to determine the role of blood parameters in the diagnosis and prognostication of APE. Material and Method: This study was conducted retrospectively on patients who had been admitted to our hospital’s emergency department (ED) and diagnosed with APE. Patients with an RV/LV ratio greater than 0,9 on Computed tomography (CT) and hypotension were grouped as massive APE; patients with stable hemodynamics and an RV/LV ratio greater than 0,9 on CT were defined as submissive APE; and patients with stable hemodynamics and an RV/LV ratio smaller than 0,9 on CT were defined as non-massive APE. Results: This study enrolled a total of 200 patients, 82 of which were male (41%) and 118 were female (59%). APE group had a significantly greater D-dimer level than the control group (3.559,5±8.611.3 ng/ml vs 266.6±266.6 ng/ml) (p<0,001). Troponin I levels significantly greater in the patient group than control group (53.3±90 vs 332.9±32,9) (p= 0.013). Conclusion: Analysis of the hematological parameters between the APE subgroups showed that D-Dimer, leukocyte (WBC), neutrophil, lymphocyte, neutrophil to lymphocyte ratio (NLR), and troponin levels were significantly higher in the massive APE group than the sub-massive and non-massive APE groups.

Keywords

• Acute pulmonary embolism
• hematological parameters
• emergency

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