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C-REAKTİF PROTEİN/ALBUMİN ORANININ İLEUS TİPİNİ VE PROGNOZU BELİRLEMEDEKİ YERİ

Year 2022, Volume 29, Issue 1, 121 - 126, 01.03.2022
https://doi.org/10.17343/sdutfd.1063380

Abstract

Amaç Son zamanlarda, sistemik inflamasyon ve beslenme durumu için bu belirteçlerin bir kombinasyonu olan CRP/albümin oranı, enfeksiyon, malignite ve diğer hastalıkları olan hastalarda bağımsız bir prognostik belirteç olduğu saptanmıştır. Çalışmamızda, ileus tanısı ile hastaneye yatan hastalarda başvuru anındaki CRP-albumin oranının ileus nedenini ve prognozu tahmin etmedeki etkinliğini araştırmayı amaçladık. Gereç ve Yöntem Çalışmaya acil servise başvuran ve sonrasında ileus tanısı alan 18 yaş üstü hastalar alınmıştır. Hastaların demografik özellikleri, laboratuvar parametreleri, cerrahi müdahale geçirip geçirmedikleri, yatış süreleri ve hastane içi mortaliteleri belirlenmiştir. Etiyolojisine göre paralitik veya mekanik olarak ayrılmıştır. CRP/ albümin oranı (CAR) hesaplanmış, CAR’ın ileus nedeni ve mortaliteyi tahmin etmedeki etkisi araştırılmıştır. Bulgular Toplam 116 hasta araştırıldı. Hastaların 72 (%62,1)’si erkek, yaş ortalaması 65,12’di. 81 (%69,8)’inde mekanik ileus saptandı. İleus tiplerine göre mekanik ileus hastalarının %66,7’si medikal tedavi alırken, paralitik ileusta%97,1’i medikal tedavi aldığı saptandı. Paralitik ileus hastalarında tedavi tercihi daha fazla orandı medikaldi (p<0,001). Mekanik ileus olan hastaların CAR değeri 3,72, paralitik ileus olanların ise 5,77 saptandı. (p=0,046) Bütün ileus hastalarında CAR, WBC, yatış süresi, nötrofil ve lenfosit sayısı, CRP değerinin incelendiği lojistik regresyon analizinde hiçbir parametrenin mortalite için bağımzsız bir gösterge olmadığı ortaya çıkmıştır. Sonuç CAR değeri ileus tipini belirlemede faydalı olabilir. İleus hastalarında mortalite tahmininde yararlı görülebilirken bağımsız bir gösterge değildir.

References

  • Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000; 87: 1240–1247.
  • Thijs, L.G.; Hack, C.E. Time course of cytokine levels in sepsis. Intensiv. Care Med. 1995, 21, S258–S263.
  • Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703.
  • Kim, M.H.; Ahn, J.Y.; Song, J.E.; Choi, H.; Ann, H.W.; Kim, J.K.; Kim, J.H.; Jeon, Y.D.; Kim, S.B.; Jeong, S.J.; et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS ONE 2015, 10.
  • Saito, H.; Kono, Y.; Murakami, Y.; Shishido, Y.; Kuroda, H.; Matsunaga, T.; Fukumoto, Y.; Osaki, T.; Ashida, K.; Fujiwara, Y. Prognostic significance of the preoperative ratio of C-reactive protein to albümin and neutrophil-lymphocyte ratio in gastric cancer patients. World J. Surg. 2017.
  • Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin Ratio be Used as a New Indicator of Activation in Patients with Uveitis? Ocul Immunol Inflamm. 2021 Jul 4;29(5):1017-1022. doi: 10.1080/09273948.2020.1714061.
  • Kim M, Park YG, Park YH. C-reactive protein/albumin ratio as an indicator of disease activity in Behçet's disease and human leukocyte antigen-B27-associated uveitis. Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1985-1992.
  • Liu A, Lv H, Tan B, Shu H, Yang H, Li J, Qian J. Accuracy of the highly sensitive C-reactive protein/albumin ratio to determine disease activity in inflammatory bowel disease. Medicine (Baltimore). 2021 Apr 9;100(14): e25200.
  • Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget. 2018 Jan 11;9(17):13934-13947.
  • Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC. Ileus in Adults. Dtsch Arztebl Int. 2017 Jul 24;114(29-30):508-518.
  • Vilz TO, Pantelis D, Kalff JC. Prophylaxis and therapy of postoperative ileus. Chirurgische Praxis. 2013; 76:407–420.

THE ROLE OF C-REACTIVE PROTEIN/ALBUMIN RATIO IN DETERMINING ILEUS TYPE AND PROGNOSIS

Year 2022, Volume 29, Issue 1, 121 - 126, 01.03.2022
https://doi.org/10.17343/sdutfd.1063380

Abstract

Objective Recently, the CRP / albumin ratio, a combination of blood markers for systemic inflammation and nutritional status, has been found to be an independent prognostic marker in patients with infection, malignancy, and other diseases. In our study, we aimed to investigate the effectiveness of the CRP-albumin ratio at admission in predicting the ileus type and prognosis in hospitalized patients. Material and Methods Patients over the age of 18 who applied to the emergency department and were later diagnosed with ileus were included in the study. Demographic characteristics, laboratory parameters, surgical intervention, length of stay and in-hospital mortality of the patients were determined. It is divided into paralytic or mechanical according to its etiology. The CRP/albumin ratio (CAR) was calculated, and the effect of CAR in predicting the ileus type and mortality was investigated. Results A total of 116 patients were investigated. 72 (62.1%) of the patients were male and the mean age was 65.12 years. Mechanical ileus was detected in 81 (69.8%) of them. According to ileus types, 66.7% of patients with mechanical ileus received medical treatment, while 97.1% of patients with paralytic ileus received medical treatment. Medical treatment was more common in patients with paralytic ileus (p<0.001). The CAR value was found to be 3.72 in patients with mechanical ileus and 5.77 in patients with paralytic ileus (p=0.046). In the logistic regression analysis examining CAR, WBC, length of stay, neutrophil and lymphocyte count, and CRP value in all ileus patients, it was revealed that no parameter was an independent indicator for mortality. Conclusion The CAR value can be useful in determining ileus type. While it may be useful in predicting mortality in ileus patients, it is not an independent indicator.

References

  • Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000; 87: 1240–1247.
  • Thijs, L.G.; Hack, C.E. Time course of cytokine levels in sepsis. Intensiv. Care Med. 1995, 21, S258–S263.
  • Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703.
  • Kim, M.H.; Ahn, J.Y.; Song, J.E.; Choi, H.; Ann, H.W.; Kim, J.K.; Kim, J.H.; Jeon, Y.D.; Kim, S.B.; Jeong, S.J.; et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS ONE 2015, 10.
  • Saito, H.; Kono, Y.; Murakami, Y.; Shishido, Y.; Kuroda, H.; Matsunaga, T.; Fukumoto, Y.; Osaki, T.; Ashida, K.; Fujiwara, Y. Prognostic significance of the preoperative ratio of C-reactive protein to albümin and neutrophil-lymphocyte ratio in gastric cancer patients. World J. Surg. 2017.
  • Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin Ratio be Used as a New Indicator of Activation in Patients with Uveitis? Ocul Immunol Inflamm. 2021 Jul 4;29(5):1017-1022. doi: 10.1080/09273948.2020.1714061.
  • Kim M, Park YG, Park YH. C-reactive protein/albumin ratio as an indicator of disease activity in Behçet's disease and human leukocyte antigen-B27-associated uveitis. Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1985-1992.
  • Liu A, Lv H, Tan B, Shu H, Yang H, Li J, Qian J. Accuracy of the highly sensitive C-reactive protein/albumin ratio to determine disease activity in inflammatory bowel disease. Medicine (Baltimore). 2021 Apr 9;100(14): e25200.
  • Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget. 2018 Jan 11;9(17):13934-13947.
  • Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC. Ileus in Adults. Dtsch Arztebl Int. 2017 Jul 24;114(29-30):508-518.
  • Vilz TO, Pantelis D, Kalff JC. Prophylaxis and therapy of postoperative ileus. Chirurgische Praxis. 2013; 76:407–420.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Araştırma Makaleleri
Authors

Bora ÇEKMEN> (Primary Author)
KARABÜK ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-3348-8375
Türkiye


Giray KOLCU>
SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-8406-5941
Türkiye

Publication Date March 1, 2022
Application Date January 26, 2022
Acceptance Date February 1, 2022
Published in Issue Year 2022, Volume 29, Issue 1

Cite

Vancouver Çekmen B. , Kolcu G. C-REAKTİF PROTEİN/ALBUMİN ORANININ İLEUS TİPİNİ VE PROGNOZU BELİRLEMEDEKİ YERİ. SDÜ Tıp Fakültesi Dergisi. 2022; 29(1): 121-126.

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Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/ Medical Journal of Süleyman Demirel Universty Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.