Hiperemezis gravidarum hastalarında uzun süreli hospitalizasyonun ve tekrarlayan hastane yatışlarının göstergeleri

Abstract

Amaç: Hiperemesis Gravidarum (HG), gebe kadınların yaşam kalitesini önemli ölçüde etkileyebilir ve gebeliğin ilk yarısında hastaneye yatışa yol açan birincil faktördür. Bu çalışmanın amacı, HG'nin şiddetini belirleyen temel laboratuvar göstergelerinin ve bunlardan hesaplanabilen endekslerin, toplam hastanede kalış süresini ve tekrarlayan hastaneye yatış sayısını tahmin etme yeteneğini belirlemektir. Yöntemler: 2018-2021 yılları arasında üçüncü basamak bir hastanede HG tanısı konulan kadınlar üzerinde retrospektif bir analiz yürütüldü. Dahil etme kriterlerinin uygulanmasının ardından, toplam 100 uygun HG hastası (çalışma grubu) ve 130 sağlıklı gebe kadın (kontrol grubu) çalışmaya dahil edildi. Daha sonra gruplar karşılaştırmalı bir analize tabi tutuldu. Bulgular: Çalışma grubunda hemoglobin, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), kırmızı kan hücresi (RBC), beyaz kan hücresi (WBC), nötrofil, ortalama trombosit hacmi (MPV), ketonüri düzeyleri daha yüksek ve tiroid uyarıcı hormon (TSH) ve eozinofil düzeyleri daha düşüktü (hepsi için p<0,005). Ayrıca nötrofil-lenfosit oranı (NLR), sistemik immün inflamasyon indeksi (SII), sistemik inflamatuar yanıt indeksi (SIRI) ve AST/trombosit oranı indeksi (APRI) (hepsi için p<0,05) çalışma grubunda kontrol grubuna göre anlamlı olarak daha yüksekti; ancak serum delta nötrofil indeksi (DNI), trombosit-lenfosit oranı (PLR), monosit-lenfosit oranı (MLR) ve pan-immün inflamasyon değeri (PIV) her iki grupta istatistiksel olarak benzerdi. Sonuç: Bildiğimiz kadarıyla bu çalışma, HG hastalarında laboratuvar parametreleriyle birlikte toplam hastanede kalış süresinin ve tekrarlayan hastane yatışlarının sayısının tahminini araştıran ilk çalışmadır. NLR, SII, SIRI, APRI, WBC, AST, nötrofil ve ketonüri, HG tanısı ve tekrarlayan hastane yatışının ve hastane yatış süresinin tahmini için değerli, ekonomik olarak uygulanabilir ve kolayca kullanılabilecek göstergeler olarak hizmet etme potansiyeline sahiptir.

Keywords

• Hiperemesis gravidarum
• tam kan sayımı
• ketonüri
• hastaneye yatış
• yeniden hastaneye yatışın öngörülmesi

Indicators of prolonged hospital stay and rehospitalizations in hyperemesis gravidarum

Abstract

Aims: Hyperemesis gravidarum (HG) can significantly impact the quality of life of pregnant women and is the primary factor leading to hospitalization during the first half of the pregnancy. The aim of this study is to determine the ability of basic laboratory indicators that determine the severity of HG and the indices that can be calculated from them to predict the total length of hospital stay and the number of recurrent hospitalizations. Methods: A retrospective analysis was conducted on women diagnosed with HG at a tertiary hospital from 2018 to 2021. Following the application of the inclusion criteria, we included a total of 100 eligible patients with HG (study group) and 130 healthy pregnant women (control group). Subsequently, the groups were subjected to a comparative analysis. Results: The study group had higher levels of hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), red blood cell (RBC), white blood cells (WBC), neutrophil, mean platelet volüme (MPV), ketonuria, and lower levels of thyroid-stimulating hormone (TSH), eosinophil (p<0.005, for all). Additionally, neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), systemic inflammatory response index (SIRI), and AST to platelet ratio index (APRI) (p<0.05, for all) were significantly higher in the study group than in the control group, but serum delta neutrophil index (DNI), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and pan-immune inflammation value (PIV) were statistically similar in both groups. Conclusion: To the best of our knowledge, this is the first study to investigate the prediction of total hospital stay along with the number of recurrent hospitalizations with laboratory parameters in HG patients. The NLR, SII, SIRI, APRI, WBC, AST, neutrophil, and ketonuria have the potential to serve as valuable, economically viable, and readily available objective indicators for the diagnosis of HG and the prediction of recurrent hospitalization and duration of hospitalization.

Keywords

• Hyperemesis gravidarum
• complete blood count
• ketonuria
• hospitalization
• predicting rehospitalization

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