Comparison of WBC / MPV Ratio with the Well's Score in Patients with Pulmonary Embolism at Emergency Department

Yıl 2021, Cilt: 4 Sayı: 3, 83 - 89, 30.09.2021

Neşe Gül Karabaş Melih Yüksel Halil Kaya Mehmet Oğuzhan Ay Bişar Sezgin Yeşim İşler Mehtap Bulut

Öz

Aim: This study aims to compare the WBC / MPV ratio with the Wells clinical probability score in patients admitted to the emergency department with the suspicion of Pulmonary Embolism (PE) and to investigate whether this ratio can be used as a marker in determining prognosis.

Material and Methods: A total of 111 patients who presented to the emergency department between 01 September 2019 and 31 August 2020 and met the criteria were included in the study. The Well's score was used to evaluate patients' clinical probability of PE. According to the Wells scores, patients were divided into 3 as low, moderate and high-risk groups. In addition, the WBC / MPV ratio (WMR) obtained from the patients' first admission hemograms were calculated.

Results: The median age of the patients in the study was 65 (IQR 25-75: 57-79). 56 of the patients (50.5%) were female and PE was detected in 68 (61.3%). It was observed that the mean WBC level was significantly different in the group with PE (p <0.05). There was no statistically significant difference between MPV and WMR levels with PE groups. There was no statistically significant difference between the mean WBC, MPV, and WMR levels with the 28-day mortality. Additionally, there was no statistically significant difference between the Wells scores of the patients in the low, moderate and high-risk groups with WBC, MPV and WMR levels. In Pearson correlation analysis, there was no relationship between WBC, MPV and WMR levels with the Well's scores.

Conclusion: It was found that the WMR value, a simple, cheap and accessible test, is insufficient to predict the 28-day mortality in patients with PE. No correlation was identified between WMR values and Wells scores. WBC elevation was found to be significantly higher in those with a diagnosis of PE. It was determined that the use of WMR as a pre-test in the diagnosis of PE is not beneficial.

Anahtar Kelimeler

Emergency department, pulmonary embolism, Wells score, mortality, D-dimer

Comparison of WBC / MPV Ratio with the Well's Score in Patients with Pulmonary Embolism at Emergency Department

Öz

Amaç: Bu çalışmanın amacı acil servise Pulmoner Emboli (PE) şüphesi ile başvuran olgularda WBC/MPV oranın Wells klinik olasılık skoru ile karşılaştırmak ve prognozu belirlemede bir belirteç olarak kullanılıp kullanılamayacağını araştırmaktır.

Gereç ve Yöntemler: 01 Eylül 2019 ile 31 Ağustos 2020 arasında acil servise başvuran ve kriterleri karşılayan toplam 111 hasta çalışmaya dâhil edildi. Hastaların PE klinik olasılık değerlendirilmesi için Wells skoru kullanıldı. Wells skorunda ise hastalar düşük, orta ve yüksek riskli olarak 3 gruba ayrıldı. Ayrıca hastaların ilk başvuru hemogramlarından elde edilen WBC/ MPV oranı (WMO) hesaplandı.

Bulgular: Çalışmaya dâhil edilen hastaların ortanca yaşı 65 ( IQR 25-75: 57-79) yıldı. Hastaların 56’sı (%50.5) kadın olup, 68’inde ( %61.3) PE saptandı. Ortalama WBC düzeyinin PE tanılı grupta anlamlı derecede farklı olduğu görüldü (p<0.05). MPV ve WMO düzeyleri ile PE grupları arasında istatistiksel olarak anlamlı bir fark bulunamadı. Ortalama WBC, MPV ve WMO düzeyleri ile 28 günlük mortalite arasında istatistiksel olarak anlamlı bir fark bulunamadı. Düşük, orta ve yüksek riskli Wells skorları ile WBC, MPV ve WMO düzeyleri arasında istatistiksel olarak anlamlı bir fark saptanmadı. Pearson korelasyon analizinde WBC, MPV ve WMO düzeyleri ile Wells skor değerleri arasında bir korelasyon saptanmadı.

Sonuç: Basit, ucuz ve ulaşılabilir bir test olan WMO değerinin, PE’li hastalarda 28 günlük mortaliteyi öngörmede yetersiz olduğunu saptadık. WMO değerleri ile Wells skorları arasında bir korelasyon saptayamadık. WBC yüksekliği PE tanısı olanlarda anlamlı olarak yüksek bulundu. WMO’nun PE tanısında ön test olarak kullanımının faydalı olmadığı tespit edildi.

Anahtar Kelimeler

Acil servis, pulmoner emboli, Wells skoru, mortalite, D-dimer

Kaynakça

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