THE EFFECT OF BLOOD PARAMETERS ON EMERGENCY DEPARTMENT FOLLOW-UP TIME AND HOSPITALIZATION STATUS IN COPD

Öz

BACKGROUND AND AIM Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways and lungs. Neutrophils are the blood cells that respond most early to inflammation. In many studies, the Neutrophil/Lymphocyte ratio has been shown to be an important component of the inflammatory response. RDW is a routine component of the hemogram, which shows heterogeneity in erythrocyte size and is used as a laboratory value for anemia. Research has shown that high RDW can be used as an indicator of poor prognosis in COPD. We aimed to show the effect of NLR and RDW values on morbidity by examining the correlation with length of hospital stay in COPD patients. MATERIALS AND METHODS Complete blood count data and length of hospital stay of COPD patients who were admitted to the emergency department of our hospital with symptoms of COPD exacerbation in the last six months were investigated retrospectively. The relationship between RDW values in complete blood count and neutrophil/lymphocyte ratios (NLR) in the emergency department and inpatient admission rates was examined. RESULTS A total of 101 patients, 69.3% of whom were male, were diagnosed with COPD and admitted to the emergency department with acute respiratory failure were included in the study. As a result of the statistical study, there is a significant difference in RDW-SW and NLR values according to the length of stay in the emergency department. CONCLUSION In our study, we observed that patients with higher RDW and NLR values had longer hospital stays. This has shown that RDW and NLR measurements may be important in determining the morbidity of the disease.

Anahtar Kelimeler

• COPD
• COPD exacerbation (AECOPD)
• NLR
• RDW
• Length of hospital stay (LOS).

KOAH’TA KAN PARAMETRELERİNİN ACİL SERVİS TAKİP SÜRESİ VE YATIŞ DURUMUNA ETKİSİ

Öz

GİRİŞ ve AMAÇ Kronik obstrüktif akciğer hastalığı (KOAH), hava akışını azalması ile karakterize, akciğer dokusunda hasara neden olan solunum yollarının ve akciğerlerin kronik enflamatuar bir hastalığıdır. Nötrofiller, inflamasyona en erken yanıt veren kan hücreleridir. Birçok çalışmada Nötrofil/Lenfosit oranının inflamatuar yanıtın önemli bir bileşeni olduğu gösterilmiştir. RDW, eritrosit boyutunda heterojenlik gösteren ve anemi için bir laboratuvar değeri olarak kullanılan hemogramın rutin bir bileşenidir. Araştırmalar, yüksek RDW'nin KOAH'da kötü prognozun bir göstergesi olarak kullanılabileceğini göstermiştir. Biz de NLR ve RDW değerlerinin KOAH hastalarında hastanede kalış süresiyle korellasyonunu inceleyerek morbidite üzerindeki etkisini göstermeyi amaçladık. MATERYAL VE METOD Son altı ayda hastanemiz acil servisine KOAH alevlenme semptomlarıyla başvuran KOAH hastalarının tam kan sayımı verileri ve hastanede kalış süreleri retrospektif olarak araştırılmıştır. Tam kan sayımında yer alan RDW değerleri ile Nötrofil/Lenfosit oranlarının (NLR) acil serviste kalış süreleri ve yataklı servislere yatırılma oranları arasındaki ilişki incelenmiştir. BULGULAR Çalışmaya toplamda KOAH tanısı olan ve acil servise akut solunum yetmezliği ile başvuran, %69,3’ü erkeklerden oluşan 101 hasta dahil edilmiştir. Yapılan istatistiksel çalışma sonucunda RDW-SW ve NLR değerleri acil serviste kalış süresine göre anlamlı farklılık görülmektedir. Ayrıca RDW ve NLR değerlerinin birbiriyle korelasyonu hesaplandığında da sonuçlar istatistiksel olarak anlamlı bulunmuştur. SONUÇ Çalışmamızda RDW ve NLR değeri daha yüksek olan hastaların hastanede kalış sürelerinin daha uzun olduğunu gözlemledik. Bu durum hastalığın morbiditesini belirlemede RDW ve NLR ölçümlerinin önemli olabileceğini göstermiştir.

Kaynakça

1. 1. Alparslan Bekir, S., Tuncay, E., Güngör, S., Yalcinsoy, M., Sogukpinar, Ö., Gundogus, B., ... & Karakurt, Z. (2021). Can red blood cell distribution width (RDW) level predict the severity of acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?. International Journal of Clinical Practice, 75(11), e14730.
2. 2. Eraslan, B. Z., Cengiz, S. K., Sagmen, S. B., Yalçınkaya, K. Z., Kıral, N., & Cömert, S. (2024). The importance of the erythrocyte distribution width/albumin ratio in patients with chronic obstructive pulmonary disease exacerbation. Saudi Medical Journal, 45(1), 27.
3. 3. Wang, H. H., & Cheng, S. L. (2021). From Biomarkers to Novel Therapeutic Approaches in Chronic Obstructive Pulmonary Disease. Biomedicines, 9(11), 1638.
4. 4. Cakmak, F., & Tekin, E. (2022). Correlation of the end-tidal CO2 value with arterial blood gas parameters–evaluation of the treatment efficacy of COPD exacerbation in the emergency department. European Journal of Clinical and Experimental Medicine 2022; 20 (3): 316–322
5. 5. Liu, S., Zhang, H., Zhu, P., Chen, S., & Lan, Z. (2024). Predictive role of red blood cell distribution width and hemoglobin-to-red blood cell distribution width ratio for mortality in patients with COPD: evidence from NHANES 1999–2018. BMC Pulmonary Medicine, 24(1), 413.
6. 6. Luo, R., Hu, J., Jiang, L., & Zhang, M. (2016). Prognostic value of red blood cell distribution width in non-cardiovascular critically or acutely patients: a systematic review. PLoS One, 11(12), e0167000.
7. 7. Seyhan, E. C., Özgül, M. A., Tutar, N., Ömür , I. M., Uysal, A., & Altin, S. (2013). Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD: Journal of Chronic Obstructive Pulmonary Disease, 10(4), 416-424.
8. 8. Sincer, I., Zorlu, A., Yilmaz, M. B., Dogan, O. T., Ege, M. R., Amioğlu, G., ... & Tandogan, I. (2012). Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease. Heart & Lung, 41(3), 238-243.

9. 9. Günay, E., Sarınç Ulaşlı, S., Akar, O., Ahsen, A., Günay, S., Koyuncu, T., & Ünlü, M. (2014). Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study. Inflammation, 37, 374-380.
10. 10. Salvagno, G. L., Sanchis-Gomar, F., Picanza, A., & Lippi, G. (2015). Red blood cell distribution width: a simple parameter with multiple clinical applications. Critical reviews in clinical laboratory sciences, 52(2), 86-105.
11. 11. Şahin, F., Kosar, A. F., Aslan, A. F., Yiğitbaş, B., & Uslu, B. (2019). Serum biomarkers in patients with stable and acute exacerbation of chronic obstructive pulmonary disease: a comparative study. Journal of medical biochemistry, 38(4), 503.
12. 12. Rahimirad, S., Ghafari, M., Ansarin, K., Rashidi, F., & Rahimi-Rad, M. H. (2016). Elevated red blood cell distribution width predicts mortality in acute exacerbation of COPD. Pneumologia (Bucharest, Romania), 65(2), 85-89.
13. 13. Tertemiz, K. C., Alpaydin, A. O., Sevinç, C., Ellidokuz, H., Acara, A. C., & Cimrin, A. (2016). Could "red cell distribution width" predict COPD severity? Revista Portuguesa de Pneumologia (English Edition), 22(4), 196-201.
14. 14. Kurtoglu, E., Aktürk, E., Korkmaz, H., Sincer, I., Yılmaz, M., Erdem, K., ... & Özdemir, R. (2013). Elevated red blood cell distribution width in healthy smokers. Turkish Cardiol Dern Res, 41(3), 199-206.
15. 15. Bai, Y., & Tao, X. N. (2020). Mean platelet volume combined red cell distribution width as biomarker of chronic obstructive pulmonary disease with pulmonary heart disease. The Clinical Respiratory Journal, 14(12), 1122-1130.
16. 16. Ren, H., Hua, Q., Quan, M., Chen, H., Hou, H., Wang, L., ... & Yang, Z. (2013). Relationship between the red cell distribution width and the one-year outcomes in Chinese patients with stable angina pectoris. Internal medicine, 52(16), 1769-1774.
17. 17. Wang, J., Wan, Z., Liu, Q., Wang, B., Wang, L., Yang, D., ... & Zhu, R. (2020). Predictive value of red blood cell distribution width in chronic obstructive pulmonary disease patients with pulmonary embolism. Analytical Cellular Pathology, 2020(1), 1935742.
18. 18. Özgül, G., Seyhan, E. C., Özgül, M. A., & Günlüoğlu, M. Z. (2017). Red blood cell distribution width in patients with chronic obstructive pulmonary disease and healthy subjects. Archivos de Bronconeumología (English Edition), 53(3), 107-113.
19. 19. Kim, C. H., Park, J. T., Kim, E. J., Han, J. H., Han, J. S., Choi, J. Y., ... & Oh, H. J. (2013). An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Critical care, 17, 1-8
20. 20. Yao, C., Liu, X., & Tang, Z. (2017). Prognostic role of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio for hospital mortality in patients with AECOPD. International journal of chronic obstructive pulmonary disease, 2285-2290.