Neutrophil/Monocyte Ratio: A new predictor of inhospital mortality in patients with spontaneous ascites infections

Yıl 2020, , 243 - 252, 19.01.2021

Ferit Çelik Nalan Ünal Ali Şenkaya , İlkçe Kurtulmuş Seymur Aslanov Sabire Aydemir Fatih Tekin , Ahmet Özütemiz Fulya Günşar , Zeki Karasu

https://doi.org/10.5505/deutfd.2020.53325

Öz

Objective: To determine the clinical features and in-hospital mortality predictors of spontaneous ascites infection (SAI).
Materials and Methods: In this retrospective study, 496 patients with liver cirrhosis hospitalized at the gastroenterology clinic between 2015-2019 were screened. Of the 304 cases with ascites, 80 diagnosed with SAI were included in the study.
Results: Spontoneus ascites infections (SAI) was detected in 80 (16.1%) of 496 hospitalized patients with cirrhosis. In cirrhotic patients with SAI, the most common reason for presentation to the hospital was altered mental status, which was observed in 26 (32.5%) patients. Thirty-one (38.8%) patients were diagnosed with spontaneous bacterial peritonitis, 41 (51.2%) with culture-negative neutrocytic ascites, eight (10%) with monomicrobial non-neutrocytic bacteria ascites. In-hospital mortality was observed in 25 (31.3%) patients, and one-year mortality rate was 35% with total 28 patients. A high MELD-Na score, history of SAI, presence of hepatic encephalopathy at the time of hospitalization, and a neutrophil/monocyte ratio of >9.1 were determined as the predictors of in-hospital mortality. A neutrophil/monocyte ratio of >9.1 predicted in-hospital mortality at 72% sensitivity and 62% specificity.
Conclusion: Successfully predicting mortality in SAI, easily calculated by a hemogram examination, and providing inexpensive, effective and fast results, neutrophil/monocyte ratio presents as a useful marker.

Anahtar Kelimeler

cirrhosis, ascites, spontaneous ascites infection, mortality, neutrophil/monocyte ratio

Nötrofil/Monosit Oranı: Spontan assit enfeksiyonlarında hastane içi mortalite için yeni bir gösterge

Öz

Amaç: Bu çalışmanın amacı spontan assit enfeksiyonunun (SAI) klinik özelliklerinin ve hastane içi mortalite prediktörlerinin belirlenmesidir.
Gereç ve Yöntem: Bu çalışma retrospektif bir çalışmadır. Ocak 2015-Haziran 2019 arasında Gastroenteroloji bilim dalında yatan 496 karaciğer siroz hastası taranmıştır. 304 assitli olgudan SAI saptanan 80 olgu çalışmaya dâhil edilmiştir. Hastaların demografik, klinik ve laboratuar verileri kaydedilmiştir.
Bulgular: Siroz tanısı ile yatan 496 olgudan 80 (%16,1)’inde SAI saptanmıştır. En sık hastaneye başvuru nedeni bilinç bulanıklığı olup, 26 hastada (%32,5) gözlenmiştir. Hastaların 31 (%38,8)’i spontan bakteriyel peritonit, 41 (%51,2)’i kültür-negatif nötrositik assit ve 8(%10)’i monomikrobiyal non-nötrositik bakterassit tanısı almıştır. Hastane içi mortalite 25 (%31,3) hastada gözlenmiş olup, bir yıllık total mortalite %35 oranında, toplam 28 hastada görülmüştür. Yüksek MELD-Na skoru, öyküde SAI, yatışta hepatik ensefalopati varlığı ve nötrofil/monosit oranının >9,1 olması hastane içi mortalite prediktörleri olarak saptanmıştır. Nötrofil/monosit oranının >9,1 olması hastane içi mortaliteyi %72 sensitivite ve %62 spesifite ile predikte etmiştir.
Sonuç: Nötrofil/monosit oranının, SAI’de mortaliteyi predikte etmesi, hemogram tetkikinden basit olarak hesaplanabilmesi, ucuz, efektif ve hızlı sonuç vermesi nedeniyle bir belirteç olarak kullanılabileceği düşünülmüştür.

Anahtar Kelimeler

siroz, assit, spontan assit enfeksiyonu, mortalite, nötrofil/monosit oranı

Kaynakça

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