Akut Pankreatit Hastalarında Trombosit İndeksleri ile Uzamış Yatış Arasındaki İlişki: Retrospektif Gözlemsel Bir Çalışma

Öz

Amaç: Akut pankreatitli hastalarda uzamış yatış ile trombosit sayısı, ortalama trombosit hacmi, trombosit kitle indeksi, platelet dağılımı ve plateletkrit değerleri arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışma, Haziran 2017 ile Temmuz 2021 tarihleri arasında üçüncü basamak akademik acil serviste akut pankreatit tanısı alan tüm hastaların retrospektif bir kohort çalışması olarak yürütüldü. Hastalar, hastanenin bilgisayar tabanlı veri sistemi kullanılarak kayıt altına alındı. Yedi günden uzun süren yatışlar uzamış yatış olarak kabul edildi. Bulgular: Ortanca yaşı 58 olan (25-75 persentil: 43,5-75) 752 hasta çalışmaya dahil edildi. Kaydedilen hastaların ortanca hastanede kalış süresi 4 gündü (25-75. persentil: 3-7). 166 hastanın yatış süresi uzamış yatış olarak değerlendirildi ve uzamış yatış oranı %22.1 idi. Trombosit indeksleri için univariant analizde istatistiksel olarak anlamlı bir fark olmadığını gösterildi [Platelet sayısı (p=0,543), ortalama trombosit hacmi (p=0,656), trombositkrit (p=0,427), trombosit dağılım genişliği (p=0,497) ve trombosit kitle indeksi (p=0,484)]. Sonuç: Trombosit indeksleri ile hastanede yatış süresinin uzaması arasında net bir ilişki yoktur ve akut pankreatitli hastalarda hastanede yatış süresinin uzamasını öngöremezler.

Anahtar Kelimeler

• trombosit sayısı
• ortalama trombosit hacmi
• akut pankreatit
• uzamış yatış
• trombosit kitle indeksi

Relationship Between Platelet Indices and Prolonged Hospitalization in Patients with Acute Pancreatitis: A Retrospective Observational Study

Öz

Aim: To investigate relationship between platelet count, platelet mass index, mean platelet volume, platelet distribution width and plateletcrit and prolonged hospitalization in patients with acute pancreatitis. Material and Method: This study was conducted as a retrospective cohort study of all patients with acute pancreatitis from a tertiary level, academic emergency department between June 2017 and July 2021. Demographics, comorbidities, laboratory parameters, length of stay in the hospital and 30-day mortality information of the patients were recorded using computer-based data system of the hospital. Hospitalizations lasting longer than 7 days were considered as prolonged hospitalization. Results: 752 patients with a median of age of 58 years (25th-75th percentiles: 43.5-75) were included in the study. The median length of hospital stay of the enrolled patients was 4 days (25th-75th percentiles: 3-7). The hospitalization of 166 patients was prolonged, and the prolonged hospitalization rate was 22.1%. The univariate analysis for platelet indices showed that there was no statistically significant difference [Platelet count (p=0.543), mean platelet volume (p=0.656), plateletcrit (p=0.427), platelet distribution width (p=0.497), and platelet mass index (p=0.484)]. Conclusion: There is no clear relationship between platelet indices and prolonged hospitalization and they could not be predictors of prolonged hospitalization in patients with acute pancreatitis.

Anahtar Kelimeler

• platelet count
• mean platelet volume
• acute pancreatitis
• prolonged hospitalization
• platelet mass index

Kaynakça

1. Kokulu K, Günaydın YK, Akıllı NB, et al. Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol 2018;29(6):684-91.
2. Özdemir S, Algın A. The Role of Platelet Indices in Predicting Short-Term Mortality in Elderly Patients with Pulmonary Embolism. J Contemp Med 2021;11(6):833-7.
3. Rawish E, Nording H, Münte T, Langer HF. Platelets as Mediators of Neuroinflammation and Thrombosis. Front Immunol 2020;11:548631.
4. Shannon O. The role of platelets in sepsis. Res Pract Thromb Haemost 2020;5(1):27-37.
5. Ekin N, Araç E, Araç S. Can Hematological Parameters Predict the Severity of Acute Pancreatitis? Duzce Med J 2020;22(2):79-83.
6. Kefeli A, Basyigit S, Özgür Yeniova A, Küçükazman M, Nazligül Y, Aktas B. Platelet Number and Indexes during Acute Pancreatitis. Euroasian J Hepatogastroenterol 2014;4(2):67-9.
7. Leppäniemi A, Tolonen M, Tarasconi A, et al 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg 2019;14:27.
8. Algın A, Özdemir S. Evaluation of The Predictability of Platelet Mass Index for Short-Term Mortality in Patients with COVID 19:A Retrospective Cohort Study. J Contemp Med 2021;11(5):728-33.

9. Özdemir S, Algın A. Interpretation of the area under the receiver operating characteristic curve. Exp App Med Sci 2022;3(1):310-311.
10. Sing T, Sander O, Beerenwinkel N, Lengauer T. ROCR: visualizing classifier performance in R. Bioinformatics 2005;21(20):3940-1.
11. Akoglu EU, Özdemir S, Ak R, Ozturk TC. The Discriminative Power of Inflammatory Markers in Patients with Mild-To-Moderate Acute Pancreatitis: Mean Platelet Volume, Neutrophil-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, and Neutrophil-Monocyte Product. South Clin Ist Euras 2021;32(2):159-64
12. Yarkaç A, Köse A, Bozkurt Babuş S, Ateş F, Örekici Temel G, Ölmez A. The value of hematological parameters in acute pancreatitis. Ulus Travma Acil Cerrahi Derg 2019;25:453-60.
13. Beyazit Y, Sayilir A, Torun S, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36(2):162-8.
14. Bilgic Y, Akbulut S, Kutlu O, et al. Could platelet indices be prognostic biomarkers for mild or severe acute pancreatitis?. Int J Clin Exp Med 2016;9(7):13918-25.
15. Özdemir S, Algın A. Evaluation of Hematological Parameters in Predicting Short-Term Mortality for COVID 19 Patients with Gastrointestinal Symptoms: A Case-Control Study. J Contemp Med 2021;11(5):710-4.
16. Girgin R, Cinar O, Bulut E, Akduman B, Mungan NA. The Role of the Platelet Mass Index (PMI) as a New Prognostic Factor in Fournier’s Gangrene. African J Urol 2018;24:226-32.
17. Girgin R, Çınar Ö, Mungan NA. Are Haematological Parameters Reliable For Differential Diagnosis of Testicular Torsion and Epididymitis? J Urol Surg 2020;7(2):109-13.
18. Yazici S, Yazici M, Erer B, et al. The platelet functions in patients with ankylosing spondylitis:anti-TNF-alpha therapy decreases the mean platelet volume and platelet mass. Platelets 2010;21(2):126-31.
19. Bai Y, Liu Y, Jia L, et al. Severe acute pancreatitis in China: etiology and mortality in 1976 patients. Pancreas 2007;35(3):232-7.