Acil Servise Mantar İntoksikasyonu ile Başvuran Hastalarda Sistemik İmmün İnflamatuar İndeksin Prognostik Önemi

Abstract

Amaç Bu çalışmada, acil servise mantar intoksikasyonu nedeniyle başvuran hastalarda sistemik inflamasyon temelli biyobelirteçlerin (nötrofil/lenfosit oranı, trombosit/lenfosit oranı, monosit/lenfosit oranı, sistemik immün-inflamasyon indeksi, sistemik inflamatuar yanıt indeksi ve modifiye inflamasyon indeksleri) prognoz üzerindeki belirleyiciliği araştırılmıştır. Materyal ve Metot Bu retrospektif gözlemsel çalışmaya, Haziran 2018 ile Aralık 2024 tarihleri arasında üçüncü basamak bir hastanenin acil servisine mantar zehirlenmesi tanısıyla başvuran erişkin hastalar dahil edilmiştir. Hastalara ait demografik, klinik ve laboratuvar verileri hastane veri sisteminden elde edilmiştir. Sistemik inflamasyon indeksi ve diğer oranlar hesaplanmış, hastalar taburcu, servis yatışı ve yoğun bakım yatışı olmak üzere üç gruba ayrılmıştır. Gruplar arası karşılaştırmalar Kruskal-Wallis testi ile yapılmış, hastane yatışını öngörmedeki başarı ROC analizi ile değerlendirilmiştir. Bulgular Toplam 45 hasta (medyan yaş: 55 yıl; %48,9 kadın) çalışmaya dahil edilmiştir. NLR, PLR, MLR, SII, SIRI ve MII alt tiplerinin klinik sonlanım grupları arasında anlamlı fark göstermediği bulunmuştur (p > 0,05). ROC analizinde SII (AUC: 0,619) ve MII-3 (AUC: 0,639) en yüksek ayırt edici güce sahip olsa da sonuçlar istatistiksel olarak anlamlı bulunmamıştır. Sonuç Sistemik inflamasyon belirteçlerinin mantar intoksikasyonunda klinik sonlanımı öngörme konusunda yeterli prognostik değer taşımadığı görülmüştür. Daha geniş örneklemli, prospektif çalışmalar bu sonuçların doğrulanması açısından gereklidir.

Keywords

• inflamasyon
• mantar intoksikasyonu
• prognoz
• sistemik immün-inflamasyon indeksi
• acil servis

Prognostic Significance of the Systemic Immune-Inflammation Index in Patients Presenting to the Emergency Department with Mushroom Intoxication

Abstract

Objective This study aimed to investigate the prognostic value of systemic immune-inflammation indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and modified inflammation indices (MII-1, MII-2, MII-3), in patients presenting to the emergency department (ED) with mushroom intoxication. Materials and Methods This retrospective observational study included adult patients diagnosed with mushroom poisoning at a tertiary ED between June 2018 and December 2024. Demographic, clinical, and laboratory data were collected, and systemic inflammation-based indices were calculated. Patients were categorized according to clinical outcomes: discharge, ward admission, or intensive care unit (ICU) admission. Kruskal-Wallis and ROC analyses were performed to evaluate the predictive value of these indices for hospitalization. Results A total of 45 patients were included (median age: 55 years; 48.9% female). No significant differences were found among NLR, PLR, MLR, SII, SIRI, or MII subtypes across the outcome groups (p > 0.05 for all). ROC analysis showed poor discriminatory power for hospitalization, with the highest area under the curve (AUC) values observed for SII (0.619) and MII-3 (0.639), without statistical significance. Conclusion Systemic inflammation indices, including SII and other derived ratios, did not demonstrate sufficient predictive value for hospitalization or disease severity in mushroom intoxication. While these biomarkers may have prognostic utility in other toxicological conditions, their role in mild-to-moderate mushroom poisoning appears limited. Further prospective studies with larger cohorts and toxin-specific stratification are warranted.

Keywords

• emergency department
• inflammation
• mushroom intoxication
• prognosis
• systemic immune-inflammation index

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