Role of neutrophil-to-lymphocyte, mean platelet volume-to-platelet and platelet-to-lymphocyte ratios as predictors of disease severity in Rotavirus gastroenteritis

Yıl 2022, , 280 - 287, 26.09.2022

Deniz Güven , Dilek Sarici

https://doi.org/10.47582/jompac.1168976

Öz

Aim: In developing countries, Rotavirus Gastroenteritis (RG) is even now one of the most common causes of death and morbidity. As a result, clinicians must be extremely vigilant in detecting the presence and severity of RG. The goal of this study was to identify predictors of RG severity by analyzing complete blood counts, including neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-platelet volume (MPV/P); platelet-to-lymphocyte ratio (PLR).
Material and Method: Data were obtained retrospectively from medical records of 456 children diagnosed with RG and age-matched healthy children from University of Health and Sciences, Ankara Atatürk Sanatorium Training and Research Hospital between January 2019 and December 2021. The Vesikari Score was used to categorize disease severity as severe or mild. Variables’ prognostic effects on disease severity were equated across groups.
Results: The study included 456 children with RG. Two hundred thirty two of them were severe; 126 males; median age: 1.24 (0.41-2.36 years), 224 of them non-severe; 126 males; median age 1.52 (1.01-2.84 years). The median length of hospitalization was 5 (4-7) days for the severe group and 2 (0-3) days for the non-severe group (p<0.001). Neutrophils, monocyte, platelet, red cell distribution width, NLR, and PLR levels in RG patients were statistically significantly higher than in the control group, while hemoglobin, platelet distribution width, MPV, and MPV/P levels were lower (p<0.001). The area under the operating characteristic curve (AUC) for NLR, and MPV/P for severe disease was calculated as (0.556; and 0.709, respectively), and was all statistically significant (p<0.001). However, PLR was not found statistically significant in ROC analysis (p>0.001).
Conclusion: NLR was increased and MPV/P was decreased with the increase in severity of Rotavirus Gastroenteritis. NLR and MPV/P were useful for providing additional severity stratification in RG.

Anahtar Kelimeler

Rotavirus, children, severity, neutrophil-to-lymphocyte ratio, mean platelet volume-to -platelet volume, platelet-to-lymphocyte ratio

Rotavirüs gastroenteritinin şiddetin belirlenmesinde nötrofil lenfosit, ortamala trombosit hacmi trombosit ve trombosit lenfosit oranlarının rolü

Öz

Amaç: Gelişmekte olan ülkelerde Rotavirus gastroenteriti (RG) günümüzde bile en yaygın ölüm ve morbidite nedenlerinden biridir. Sonuç olarak, klinisyenler RG’nin varlığını ve ciddiyetini tespit etmede son derece uyanık olmalıdır. Bu çalışmanın amacı, nötrofil lenfosit oranı (NLO), ortalama trombosit hacmi trombosit oranı (OTH/T) ve trombosit lenfosit oranı (TLO) dahil olmak üzere tam kan sayımlarını analiz ederek RG şiddetinin öngörücülerini belirlemekti.
Gereç ve Yöntem: Veriler, Ocak 2019 ile Aralık 2021 tarihleri arasında Sağlık Bilimleri Üniversitesi, Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesinde de RG tanısı konan 456 çocuğun tıbbi kayıtlarından ve aynı yaştaki sağlıklı çocukların tıbbi kayıtlarından geriye dönük olarak elde edildi. Hastalık şiddetini; şiddetli veya hafif kategorize etmek için Vesikari skoru kullanıldı. Değişkenlerin hastalık şiddeti üzerindeki prognostik etkileri gruplar arasında karşılaştırıldı.
Bulgular: Çalışmaya RG’lı 456 çocuk dahil edildi. Bunlardan iki yüz otuz ikisi şiddetliydi; 126 erkek; medyan yaş: 1,24 (0,41-2,36) yıl, 224’ü şiddetli değil; 126 erkek; medyan yaş 1,52 (1,01-2,84) yıldı. Hastanede medyan kalış süresi ağır grup için 5 (4-7) gün ve ağır olmayan grup için 2 (0-3) gündü (p<0,001). RG hastalarında nötrofil, monosit, trombosit, eritrosit dağılım genişliği, NLO ve TLO düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek, hemoglobin, trombosit dağılım genişliği, OTH ve OTH/T düzeyleri ise daha düşüktü (p<0,001). ROC analizinde; NLO ve OTH/T için operasyon karakteristik eğrisi (AUC) altında kalan alan, şiddetli hastalık için (sırasıyla 0,556 ve 0,709) olarak hesaplandı ve tümü istatistiksel olarak anlamlıydı (p<0,001) fakat TLO ​​istatistiksel olarak anlamlı bulunmadı (p>0,001).
Sonuç: Rotavirüs Gastroenteritinin şiddetinin artmasıyla NLO artmış ve OTH/T azalmıştır. NLO ve OTH/T, RG’de ek şiddet sınıflandırma sağlamak için faydalı bulunmuştur.

Anahtar Kelimeler

Rotavirüs, çocuklar, şiddet, nötrofil lenfosit oranı, ortalama trombosit hacmi-trombosit oranı, trombosit lenfosit oranı

Kaynakça

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