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The effect of white blood cell and platelet values on mortality in patients with abdominal aortic aneurysm

Year 2023, Volume: 5 Issue: 2, 56 - 62, 06.09.2023
https://doi.org/10.55994/ejcc.1323023

Abstract

Objective: In this study, we aimed to investigate the relationship between preoperative inflammatory markers, length of hospital stay, and mortality in patients with abdominal aortic aneurysm (AAA) who underwent surgical repair.
Methods: A total of 83 patients diagnosed with AAA were included in the study. A complete blood count (CBC) was performed on the first visit (pre-op 0-1 hour) in all patients. Non-ruptured cases (AAA) and ruptured cases (AAA-R) were compared.
Results: 14.5% (n=12) of the patients died. Higher White blood cells and neutrophils were obtained in patients who died than in surviving patients (respectively, p=0.0002, p=0.001). Higher WBC and NALP in AAA-R patients were determined.
Conclusion: WBC and Neu's values were higher in AAA patients who died post-operatively and who were detected rupture pre-operatively but PLT and HB values were similar. Normal or near-normal HB and PLT values that will be seen in the first examination of AAA cases in the emergency department may mislead clinicians or cause them to display a more optimistic attitude.

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References

  • Michel JB, Martin-Ventura JL, Egido J, et al. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans. Cardiovasc Res. 2011;90(1):18-27.
  • Kessler V, Klopf J, Eilenberg W, Neumayer C, Brostjan C. AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis. Biomedicines. 2022;10(1):94.
  • Wei L, Bu X, Wang X, Liu J, Ma A, Wang T. Global Burden of Aortic Aneurysm and Attributable Risk Factors from 1990 to 2017. Glob Heart. 2021;16(1):35.
  • Svensjö S, Björck M, Gürtelschmid M, Djavani Gidlund K, Hellberg A, Wanhainen A. Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease. Circulation. 2011;124(10):1118-1123.
  • Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-797.
  • Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67(1):2-77.e2
  • Parkinson F, Ferguson S, Lewis P, Williams IM, Twine CP; South East Wales Vascular Network. Rupture rates of untreated large abdominal aortic aneurysms in patients unfit for elective repair. J Vasc Surg. 2015;61(6):1606-1612.
  • Patel SR, Ormesher DC, Smith SR, et al. A risk-adjusted and anatomically stratified cohort comparison study of open surgery, endovascular techniques and medical management for juxtarenal aortic aneurysms-the UK COMPlex AneurySm Study (UK-COMPASS): a study protocol. BMJ Open. 2021;11(11):e054493
  • Dahl M, Frost L, Søgaard R, Klausen IC, Lorentzen V, Lindholt J. A population-based screening study for cardiovascular diseases and diabetes in Danish postmenopausal women: acceptability and prevalence. BMC Cardiovasc Disord. 2018;18(1):20. Davis FM, Rateri DL, Daugherty A. Mechanisms of aortic aneurysm formation: translating preclinical studies into clinical therapies. Heart. 2014;100(19):1498-1505.
  • Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg. 2011;45(3):227-231.
  • Siminiak T, Flores NA, Sheridan DJ. Neutrophil interactions with endothelium and platelets: possible role in the development of cardiovascular injury. Eur Heart J. 1995;16(2):160-170.
  • Haumer M, Amighi J, Exner M, et al. Association of neutrophils and future cardiovascular events in patients with peripheral artery disease. J Vasc Surg. 2005;41(4):610-617.
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol. 1997;79(6):812-814.
  • Zhang L, Wang Y. B lymphocytes in abdominal aortic aneurysms. Atherosclerosis. 2015;242(1):311-317.
  • Lv BJ, Li J, Cheng X. T lymphocytes and aortic aneurysms. Sci China Life Sci. 2014;57(8):795-801.
  • Ntalouka MP, Nana P, Kouvelos GN, et al. Association of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio with Adverse Events in Endovascular Repair for Abdominal Aortic Aneurysm. J Clin Med. 2021;10(5):1083
  • Yıldız S, Kazğan A, Tabara M, Atmaca M. The Relationship Between Impulsivity Level and Neutrophil / Lymphocyte Ratio, Platelet/ Lymphocyte Ratio and Mean Platelet Volume in Individuals Diagnosed with Gambling Disorder. Medical Records. 2021; 3(3): 177-183.
  • Balta S, Celik T, Mikhailidis DP, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016;22(5):405-411.
  • Lareyre F, Carboni J, Chikande J, et al. Association of Platelet to Lymphocyte Ratio and Risk of 30-Day Postoperative Complications in Patients Undergoing Abdominal Aortic Surgical Repair. Vasc Endovascular Surg. 2019;53(1):5-11.
  • Kasius KM, Frijns CJ, Algra A, Rinkel GJ. Association of platelet and leukocyte counts with delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage. Cerebrovasc Dis. 2010;29(6):576-583.
  • Yun S, Yi HJ, Lee DH, Sung JH. Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Predicting the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis. 2021;30(8):105861.
  • Ko DE, Yoon HJ, Nam SB, Song SW, Lee G, Ham SY. Preoperative Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Mean Platelet Volume as Predictors of 1-Year Mortality in Patients Undergoing an Open Repair of Abdominal Aortic Aneurysms: A Retrospective Study. J Clin Med. 2021;10(22):5410.
  • Nejim B, Chau M, Ramirez Castello C, Aziz F, Flohr TR. Preoperative leukocytosis among female patients predicts poor postoperative outcomes following endovascular aneurysm repair for intact infrarenal abdominal aortic aneurysms. J Vasc Surg. 2021;74(6):1843-1852.e3.
  • Morotti A, Phuah CL, Anderson CD, et al. Leukocyte Count and Intracerebral Hemorrhage Expansion. Stroke. 2016;47(6):1473-1478.
  • Chung J, Corriere MA, Veeraswamy RK, et al. Risk factors for late mortality after endovascular repair of the thoracic aorta. J Vasc Surg. 2010;52(3):549-555.
  • Tao C, Wang J, Hu X, Ma J, Li H, You C. Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care. 2017;26(3):393-401.
  • Lareyre F, Raffort J, Le D, et al. High Neutrophil to Lymphocyte Ratio Is Associated With Symptomatic and Ruptured Thoracic Aortic Aneurysm. Angiology. 2018;69(8):686-691.
  • Çelik K, Demirel ME. Aort anevrizmaları. Yürümez Y.(Editor). Cardiovascular Emergencies. 1. Edition. Ankara: Türkiye Klinikleri; 2022. p.96-102.
Year 2023, Volume: 5 Issue: 2, 56 - 62, 06.09.2023
https://doi.org/10.55994/ejcc.1323023

Abstract

Project Number

-

References

  • Michel JB, Martin-Ventura JL, Egido J, et al. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans. Cardiovasc Res. 2011;90(1):18-27.
  • Kessler V, Klopf J, Eilenberg W, Neumayer C, Brostjan C. AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis. Biomedicines. 2022;10(1):94.
  • Wei L, Bu X, Wang X, Liu J, Ma A, Wang T. Global Burden of Aortic Aneurysm and Attributable Risk Factors from 1990 to 2017. Glob Heart. 2021;16(1):35.
  • Svensjö S, Björck M, Gürtelschmid M, Djavani Gidlund K, Hellberg A, Wanhainen A. Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease. Circulation. 2011;124(10):1118-1123.
  • Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-797.
  • Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67(1):2-77.e2
  • Parkinson F, Ferguson S, Lewis P, Williams IM, Twine CP; South East Wales Vascular Network. Rupture rates of untreated large abdominal aortic aneurysms in patients unfit for elective repair. J Vasc Surg. 2015;61(6):1606-1612.
  • Patel SR, Ormesher DC, Smith SR, et al. A risk-adjusted and anatomically stratified cohort comparison study of open surgery, endovascular techniques and medical management for juxtarenal aortic aneurysms-the UK COMPlex AneurySm Study (UK-COMPASS): a study protocol. BMJ Open. 2021;11(11):e054493
  • Dahl M, Frost L, Søgaard R, Klausen IC, Lorentzen V, Lindholt J. A population-based screening study for cardiovascular diseases and diabetes in Danish postmenopausal women: acceptability and prevalence. BMC Cardiovasc Disord. 2018;18(1):20. Davis FM, Rateri DL, Daugherty A. Mechanisms of aortic aneurysm formation: translating preclinical studies into clinical therapies. Heart. 2014;100(19):1498-1505.
  • Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg. 2011;45(3):227-231.
  • Siminiak T, Flores NA, Sheridan DJ. Neutrophil interactions with endothelium and platelets: possible role in the development of cardiovascular injury. Eur Heart J. 1995;16(2):160-170.
  • Haumer M, Amighi J, Exner M, et al. Association of neutrophils and future cardiovascular events in patients with peripheral artery disease. J Vasc Surg. 2005;41(4):610-617.
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol. 1997;79(6):812-814.
  • Zhang L, Wang Y. B lymphocytes in abdominal aortic aneurysms. Atherosclerosis. 2015;242(1):311-317.
  • Lv BJ, Li J, Cheng X. T lymphocytes and aortic aneurysms. Sci China Life Sci. 2014;57(8):795-801.
  • Ntalouka MP, Nana P, Kouvelos GN, et al. Association of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio with Adverse Events in Endovascular Repair for Abdominal Aortic Aneurysm. J Clin Med. 2021;10(5):1083
  • Yıldız S, Kazğan A, Tabara M, Atmaca M. The Relationship Between Impulsivity Level and Neutrophil / Lymphocyte Ratio, Platelet/ Lymphocyte Ratio and Mean Platelet Volume in Individuals Diagnosed with Gambling Disorder. Medical Records. 2021; 3(3): 177-183.
  • Balta S, Celik T, Mikhailidis DP, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016;22(5):405-411.
  • Lareyre F, Carboni J, Chikande J, et al. Association of Platelet to Lymphocyte Ratio and Risk of 30-Day Postoperative Complications in Patients Undergoing Abdominal Aortic Surgical Repair. Vasc Endovascular Surg. 2019;53(1):5-11.
  • Kasius KM, Frijns CJ, Algra A, Rinkel GJ. Association of platelet and leukocyte counts with delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage. Cerebrovasc Dis. 2010;29(6):576-583.
  • Yun S, Yi HJ, Lee DH, Sung JH. Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Predicting the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis. 2021;30(8):105861.
  • Ko DE, Yoon HJ, Nam SB, Song SW, Lee G, Ham SY. Preoperative Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Mean Platelet Volume as Predictors of 1-Year Mortality in Patients Undergoing an Open Repair of Abdominal Aortic Aneurysms: A Retrospective Study. J Clin Med. 2021;10(22):5410.
  • Nejim B, Chau M, Ramirez Castello C, Aziz F, Flohr TR. Preoperative leukocytosis among female patients predicts poor postoperative outcomes following endovascular aneurysm repair for intact infrarenal abdominal aortic aneurysms. J Vasc Surg. 2021;74(6):1843-1852.e3.
  • Morotti A, Phuah CL, Anderson CD, et al. Leukocyte Count and Intracerebral Hemorrhage Expansion. Stroke. 2016;47(6):1473-1478.
  • Chung J, Corriere MA, Veeraswamy RK, et al. Risk factors for late mortality after endovascular repair of the thoracic aorta. J Vasc Surg. 2010;52(3):549-555.
  • Tao C, Wang J, Hu X, Ma J, Li H, You C. Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care. 2017;26(3):393-401.
  • Lareyre F, Raffort J, Le D, et al. High Neutrophil to Lymphocyte Ratio Is Associated With Symptomatic and Ruptured Thoracic Aortic Aneurysm. Angiology. 2018;69(8):686-691.
  • Çelik K, Demirel ME. Aort anevrizmaları. Yürümez Y.(Editor). Cardiovascular Emergencies. 1. Edition. Ankara: Türkiye Klinikleri; 2022. p.96-102.
There are 28 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Original Articles
Authors

Mustafa Enes Demirel 0000-0001-5187-5737

Ufuk Turan Kürşat Kormaz 0000-0002-6107-2943

Ömer Çetin 0000-0003-3588-2077

Hatice Güldal 0000-0003-1973-5990

Mustafa Boğan 0000-0002-3238-1827

Project Number -
Early Pub Date September 6, 2023
Publication Date September 6, 2023
Submission Date July 5, 2023
Acceptance Date August 24, 2023
Published in Issue Year 2023 Volume: 5 Issue: 2

Cite

AMA Demirel ME, Kormaz UTK, Çetin Ö, Güldal H, Boğan M. The effect of white blood cell and platelet values on mortality in patients with abdominal aortic aneurysm. Eurasian j Crit Care. September 2023;5(2):56-62. doi:10.55994/ejcc.1323023

Indexing and Abstracting

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