Komplike peritonsiller apselerde pan-immün-inflamasyon değerinin prognostik önemi ve potansiyel serolojik biyobelirteçler

Abstract

Amaç: Peritonsiller apse (PTA), baş ve boynun en sık görülen derin enfeksiyonudur ve bazen yaşamı tehdit eden komplikasyonlarla ilişkili olabilir. Komplike peritonsiller apse (KPTA) olan hastalardaki klinik semptomlar her zaman bu hastalığın ciddiyetini yansıtmayabilir. Bu nedenle, bu hastaları ucuz ve kolay erişilebilir hematolojik parametrelerle izlemek esastır. Son zamanlarda, belirli inflamatuar takip belirteçleri kabul görmüştür. Bu çalışmada, komplikasyon riski yüksek PTA'lı hastalarda pan-immün inflamasyon değerinin (PIV) rolünü belirlemeyi amaçladık. Yöntemler: 10 Ekim 2022 ile 1 Ekim 2024 tarihleri arasında kliniğimize yatırılan ve PTA tanısı alan 18 yaş ve üzeri hastalar retrospektif olarak analiz edildi. Hastalar KPTA grubu ve komplikasyonsuz peritonsiller apse (UPTA) grubu olarak ikiye ayrıldı. Demografik özellikler, laboratuvar bulguları ve acil serviste gözlenen komplikasyonlar değerlendirildi. Aşağıdaki endeksler hesaplandı: nötrofil-lenfosit oranı (NLO), monosit-lenfosit oranı (MLO), trombosit-lenfosit oranı, sistemik immün-inflamasyon indeksi (SII) (trombosit sayısı × nötrofil sayısı / lenfosit sayısı olarak hesaplanır) ve PIV (nötrofil sayısı × trombosit sayısı × monosit sayısı / lenfosit sayısı olarak hesaplanır). Bulgular: Çalışmaya toplam 104 hasta dahil edildi, bunların 71'i UPTA grubunda ve 33'ü KPTA grubundaydı. NLR, MLR, SII ve PIV değerleri KPTA grubunda UPTA grubuna göre anlamlı derecede yüksekti. Alıcı işletim karakteristik eğrisi analizi kullanılarak, NLO, MLO, SII ve PIV'in PTA ile ilişkili komplikasyonları tahmin etmedeki tanısal değerleri hesaplandı. Eğriler altında kalan alanlar NLO için 0,673 (95% güven aralığı [GA]: 0,574-0,761), MLR için 0,776 (95% GA: 0,684-0,852), SII için 0,674 (95% GA: 0,575-0,763) ve PIV için 0,838'di (95% GA: 0,753-0,903). PIV değerinin > 989,6 olması %72,7 duyarlılık ve %85,9 özgüllük ile KPTA gelişimini öngördü. Sonuç: Bulgularımız PIV'ın PTA'ların şiddetini ve olası komplikasyonları öngörmede hızlı, basit ve güvenilir bir belirteç olduğunu düşündürmektedir.

Keywords

• Acil servis
• komplikasyon
• pan-immün-inflamasyon değeri
• peritonsiller apse

Prognostic importance of the pan-immune-inflammation value and potential serological biomarkers of complicated peritonsillar abscesses

Abstract

Aims: A peritonsillar abscess (PTA) is the most common deep infection of the head and neck and can sometimes be associated with life-threatening complications. Clinical symptoms in patients with a complicated peritonsillar abscess (CPTA) may not always reflect the severity of this disease. Therefore, monitoring these patients with inexpensive and easily accessible hematological parameters is essential. Recently, certain inflammatory monitoring markers have gained acceptance. In this study, we aimed to determine the role of the pan-immune-inflammation value (PIV) in patients with a PTA at a high risk of complications. Methods: Patients aged 18 years and older who were diagnosed with a PTA and hospitalized in our clinic between October 10, 2022, and October 1, 2024 were retrospectively analyzed. The patients were divided into the CPTA group and the uncomplicated peritonsillar abscess (UPTA) group. Demographic characteristics, laboratory findings, and complications observed in the emergency department were evaluated. Results: A total of 104 patients were included in the study, with 71 in the UPTA group and 33 in the CPTA group. PIV values were significantly higher in the CPTA group compared to the UPTA group. The diagnostic value of PIV in predicting PTA-related complications was assessed using receiver operating characteristic curve analysis. A PIV cutoff value of 989.6 (AUC: 0.838; 95% confidence interval: 0.753-0.903) demonstrated a sensitivity of 72.7% and a specificity of 85.9%, indicating superior predictive power for PTA-related complications compared to NLR, MLR, and SII. Conclusion: Our findings suggest that the PIV is a rapid, simple, and reliable marker for predicting the severity of PTAs and potential complications.

Keywords

• Complication
• emergency department
• pan-immune-inflammation value
• peritonsillar abscess

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