Relationship of the CRP/albumin ratio and the systemic immune-inflammation index with Forrest classification in patients with gastrointestinal bleeding

Yıl 2022, , 482 - 486, 15.03.2022

Öner Bozan , Şeref Emre Atiş

https://doi.org/10.32322/jhsm.1047503

Öz

Aim: The present study aimed to investigate CRP/albumin ratio and the systemic immune-inflammation index (SII) and Forrest classification in patients who presented to the emergency department with acute upper gastrointestinal (GI) bleeding.
Materials and Method: Patients over 18 years of age who presented to the emergency department of our hospital with melena, hematemesis, and hematochezia and were diagnosed with upper GI bleeding via esophagoduodenoscopy were included in the study. Esophagoduodenoscopy results, and accordingly, the Forrest classifications, together with complete blood count, including hemoglobin, platelet, and neutrophil values, as well as demographic characteristics were recorded. SII (calculated by multiplying the platelet count with neutrophil count and dividing the value obtained by the lymphocyte count [platelet (P)×neutrophil (N)/lymphocyte (L)]) and CRP/albumin ratio was calculated.
Results: No statistically significant difference was observed among the Forrest classification groups in terms of the median SII values as well as median CRP/albumin ratios. However, a statistically significant difference in median CRP/albumin ratios was observed among the dichotomized Forrest classification groups.
Conclusion: The SII is not a reliable parameter either predicts GI bleeding or the Forrest classification in patients with upper GI bleeding. The CRP/albumin ratio might be a poor predictor of bleeding; however, it can not predict the Forrest classification.

Anahtar Kelimeler

CRP Albumin ratio, Forrest classification, systemic immune-inflammation index, upper gastrointestinal bleeding

Kaynakça

• Kamboj AK, Hoversten P, Leggett CL. Upper gastrointestinal bleeding: etiologies and management. Mayo Clin Proc 2019; 94: 697-703.
• Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol 2012; 107: 345-60.
• Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet 1974; 17: 394-7.
• Wang R, He M, Ou X, Xie X, Kang Y. CRP Albumin ratio is positively associated with poor outcomes in patients with traumatic brain injury. Clin Neurol Neurosurg 2020; 195: 106051.
• Fest J, Ruiter R, Mulder M, et al. The systemic immune-inflammation index is associated with an increased risk of incident cancer-A population-based cohort study. Int J Cancer 2020; 1: 692-8.
• Park SH, Mun YG, Lim CH, Cho YK, Park JM. C-reactive protein for simple prediction of mortality in patients with acute non-variceal upper gastrointestinal bleeding: a retrospective analysis. Medicine (Baltimore) 2020; 99: e23689.
• Kudou K, Saeki H, Nakashima Y, et al. C-reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer. J Gastroenterol Hepatol 2019; 34: 355-63.
• Cao X, Xue J, Yang H, Han X, Zu G. Association of clinical parameters and prognosis with the pretreatment systemic immune-inflammation index (SII) in patients with gastric cancer. J Coll Physicians Surg Pak 2021; 31: 83-8.
• Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med 2020; 14: 1553-61.
• Li C, Tian W, Zhao F, et al. Systemic immune-inflammation index, SII, for prognosis of elderly patients with newly diagnosed tumors. Oncotarget 2018; 19: 35293-9.
• Gok M, Kurtul A. A novel marker for predicting severity of acute pulmonary embolism: systemic immune-inflammation index. Scand Cardiovasc J 2021; 55: 91-6.
• Bağcı A, Aksoy F, Baş HA. Systemic immune-inflammation index may predict the development of contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction. Angiology 2021; 12: 33197211030053.
• Su G, Zhang Y, Xiao R, Zhang T, Gong B. Systemic immune-inflammation index as a promising predictor of mortality in patients with acute coronary syndrome: a real-world study. J Int Med Res 2021; 49: 3000605211016274.
• Wu Z, Zhang J, Cai Y, et al. Reduction of circulating lymphocyte count is a predictor of good tumor response after neoadjuvant treatment for rectal cancer. Medicine (Baltimore) 2018; 97: e11435
• Chen Z, Shao Y, Wang K, et al. Prognostic role of pretreatment serum albumin in renal cell carcinoma: a systematic review and meta-analysis. Onco Targets Ther 2016; 28: 6701-10.
• Zhang Y, Xiao G, Wang R. Clinical significance of systemic immune-inflammation index (SII) and C-reactive protein-to-albumin ratio (CAR) in patients with esophageal cancer: a meta-analysis. Cancer Manag Res 2019; 7: 4185-200.
• Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond) 2009; 9: 30-3.
• Park SH, Mun YG, Lim CH, Cho YK, Park JM. C-reactive protein for simple prediction of mortality in patients with acute non-variceal upper gastrointestinal bleeding: a retrospective analysis. Medicine (Baltimore) 2020; 18: e23689.
• Kaptoge S, Di Angelantonio E, Lowe G, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 2010; 9: 132-40.
• Yeun JY, Levine RA, Mantadilok V, Kaysen GA. C-reactive protein predicts all-cause and cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 2000; 35: 469-76.
• Ho KM, Lee KY, Dobb GJ, Webb SA. C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: a prospective cohort study. Intensive Care Med 2008; 34: 481-7.
• Yalçın M, Kara B, Öztürk NA, Ölmez Ş, Taşdoğan BE, Taş A. Epidemiology and endoscopic findings of the patients suffering from upper gastrointestinal system bleeding. Dicle Tıp Derg 2016; 43: 73-6.
• Kandiş H, Korkut S, Korkut E. Akut üst gastrointestinal kanamalı olgularımızın endoskopik sonuçları. Duzce Med J 2010; 12: 17-20.
• Özen E, Tekin F, Oruç N, et al. Varis dışı üst gastrointestinal sistem kanamalı 412 olgunun irdelenmesi. Akademik Gastroenteroloji Derg 2007; 6: 62-7.
• Alper E, Baydar B, Çekiç C, Aslan F, Akça S, Ünsal B. Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal 2010; 18: 27-31.
• Gölgeli H, Ecirli Ş, Kutlu O, Başer H, Karasoy D. Üst gastrointestinal sistem kanaması nedeniyle izlenen hastaların değerlendirilmesi. Dicle Tıp Derg 2014; 41: 495-501.
• Okutur SK, Alkım C, Bes C, et al. Akut üst gastrointestinal sistem kanamaları: 230 olgunun analizi. Akademik Gastroenteroloji Derg 2007; 6: 30-6.