Acil Serviste Pulmoner Tromboemboli Tanısı Konulan Hastalarda Hematolojik Parametrelerin Klinik Önemi

Year 2021, Volume: 3 Issue: 3, 123 - 129, 01.11.2021

Resmiye Nur Okudan , Fevzi Yılmaz , Serkan Yüksel , Mehmet Karadaş , Adeviyye Karaca , Gizem Ayaz , Ömer Faruk Karakoyun

https://doi.org/10.38175/phnx.989396

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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