Yoğun Bakımda Pnömoni Tanılı Geriatrik Hastalarda Prognozun Nötrofil-Lenfosit Oranı, Trombosit-Lenfosit Oranı ve Nötrofil-Trombosit Oranı ile İlişkisi Var mıdır?

Öz

ÖZET Amaç: Yoğun bakım ünitesinde (YBÜ) özellikle geriatrik hastalarda sistemik inflamasyon ve enfeksiyonun erken dönemde saptanması tedavi başarısını ve mortaliteyi etkilemektedir. Bunun saptanması için günümüzde ucuz, hızlı ve kolay bir şekilde bakılan yöntemler tercih edilmektedir. Bu çalışmada pnömoni nedeni ile yoğun bakım ünitesine kabul edilen geriatrik hastaların nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve nötrofil-trombosit oranı (NPR) değerlerinin prognoz açısından değerlendirilmesi amaçlanmıştır. Yöntem: 1 Ocak 2017-1 Ocak 2020 tarihleri arasında pnömoni nedeni ile YBÜ’ye yatırılan 65 yaş ve üstü 176 hasta retrospektif olarak incelendi. Akut Fizyoloji Ve Kronik Sağlık Değerlendirmesi-II (APACHE II), Demografik veriler ve Charlson Komorbidite İndeks Skoru (CCIS), YBÜ yatış süresi, Ardışık Organ Yetmezliği Değerlendirme Skoru (SOFA), hastane yatış süresi ve 1 aylık mortalite durumları kaydedildi. YBÜ yatışları sırasında bakılan mutlak nötrofil, lenfosit ve trombosit değerleri ile hesaplanan NLR PLR ve NPR değerlerinin prognoz ve mortalite ile ilişkisi değerlendirildi. Bulgular: Çalışmamızda NLR (r:0,33; p<0,05) ve NPR değeri ile SOFA skoru arasında pozitif yönde orta düzeyde (r:0,36; p<0.05) istatistiksel olarak anlamlı bir ilişki görüldü. NPR ve CCIS skoru arasında pozitif yönde düşük düzeyde (r:0,2; p<0.05) istatistiksel olarak anlamlı bir ilişki görüldü. Bir ay içinde exitus olan hastalarda NPR değerlerinin daha yüksek saptandı (p<0,05). KOAH olan hastalarda NLR ve PLR değerlerinin daha yüksek olduğu görüldü (p<0,05). Sonuç: Çalışmamızda NPR ile CCIS arasında ve NPR ve NLR ile SOFA skoru arasında bulduğumuz pozitif ilişki, YBÜ’ye pnömoni nedenli yatışı yapılan geriatrik hastalarda NLR ve NPR değerlerindeki artışın hastaların prognozunun bir göstergesi olarak kullanılabileceğini göstermektedir. Anahtar kelimeler: Geriatrik hasta, nötrofil-lenfosit oranı, nötrofil-trombosit oranı, pnömoni, trombosit-lenfosit oranı

Anahtar Kelimeler

• geriatrik hasta
• nötrofil lenfosit oranı
• nötrofil trombosit oranı
• pnömoni
• trombosit lenfosit oranı

Is There a Relationship Between Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Neutrophil-Platelet Ratio and Prognosis in Geriatric Patients Diagnosed with Pneumonia in the Intensive Care Unit?

Öz

ABSTRACT Objective: In the intensive care unit (ICU), especially in geriatric patients, the early detection of systemic inflammation and infection impacts the success of treatment and mortality. Nowadays, methods that are cost-effective, rapid, and easy to perform are preferred for this detection. This study aims to assess the prognostic significance of the neutrophil-lymphocyte ratio (NLR), neutrophil-platelet ratio (NPR) and platelet-lymphocyte ratio (PLR) in geriatric patients admitted to the ICU due to pneumonia. Method: From January 1, 2017 to January 1, 2020, 176 patients aged 65 and above, who were admitted to the ICU due to pneumonia, were retrospectively examined. Demographic data, Sequential Organ Failure Assessment Score (SOFA), Charlson Comorbidity Index Score (CCIS), Acute Physiology And Chronic Health Evaluation-II (APACHE II), duration of ICU stay, length of hospital stay, and 1-month mortality status were documented. The relationship between prognosis and mortality was assessed in relation to the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and neutrophil-platelet ratio (NPR) values, which were determined based on the absolute neutrophil, lymphocyte, and platelet assessments acquired during ICU admissions. Results: A statistically noteworthy and moderate positive correlation was observed between NLR (r:0.33; p<0.05) and NPR values and SOFA score. Furthermore, there was a statistically notable positive correlation at a low level (r:0.2; p<0.05) between NPR and CCIS score. Additionally, NPR values were significantly elevated in patients who experienced mortality within one month (p<0.05). Moreover, NLR and PLR values were found to be elevated in patients diagnosed with COPD (p<0.05). Conclusion: Based on our study's findings, the positive correlations observed between NPR and CCIS, as well as between NPR and NLR in conjunction with the SOFA score, imply that elevated NLR and NPR values may serve as valuable indicators for assessing the prognosis of elderly patients admitted to the ICU with pneumonia. Key words: Geriatric patient, neutrophil-lymphocyte ratio, neutrophil-platelet ratio, pneumonia, platelet-lymphocyte ratio

Anahtar Kelimeler

• Geriatric patient
• neutrophil-lymphocyte ratio
• neutrophil-platelet ratio
• pneumonia
• platelet-lymphocyte ratio

Kaynakça

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