Prognostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients Who Admitted to the Emergency Department with Chronic Obstructive Pulmonary Disease Exacerbation

Yıl 2018, , 118 - 124, 31.08.2018

Gökhan Aksel

https://doi.org/10.24938/kutfd.365409

Cited By: 1

Öz

Objective: In
this study, we aimed to investigate the prognostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients
presenting with chronic obstructive pulmonary disease exacerbation.

Material and Methods: This was
a retrospective case control study. We searched the patients who admitted to
the emergency department with chronic obstructive
pulmonary disease exacerbation between 1^st January 2016 and 31th
December 2016. The patients who were discharged from emergency department or
hospitalized in wards were classified as good clinical outcome group (group 1).
The patients who were intubated and admitted to intensive care unit or the ones
who died were classified as poor clinical outcome group (group 2). We evaluated
whether there was a statistically significant difference between the two groups
according to the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and
whether these parameters effected 30 days mortality.

Results: One
thousand and sixty patients were included in the study. The hemoglobin levels,
leukocyte, neutrophil, platelet and lymphocyte counts of all patients were respectively 12,9 g/dL (11,50-14,20), 10,9
103/µL (8,42-14,60), 7,87 103/µL (5,60-11,18), 252 103/µL (197,25-311), 1,75
103/µL (1,15-2,47). Medians of neutrophil-to-lymphocyte
and platelet-to-lymphocyte ratios of all patients were 4,54 (2,64-8,15)
ve 142,08 (98,20-221,03). There were no statistically significant difference
between the groups according to the neutrophil-to-lymphocyte
and platelet-to-lymphocyte ratios (respectively p=0,1, p=0,4). There
also was not a significant relationship between the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and 30 days
mortality.

Conclusion: There
was no significant relationship between the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and poor
prognosis in patients presenting with chronic obstructive pulmonary disease
exacerbation. We believe that these parameters are not eligible markers for
predicting the prognosis in these patients.

Anahtar Kelimeler

Chronic Obstructive Pulmonary Disease, Prognoses, Mortality

ACİL SERVİSE KRONİK OBSTRÜKTİK AKCİĞER HASTALIĞI AKUT ALEVLENMESİ İLE BAŞVURAN HASTALARDA NÖTROFİL-LENFOSİT VE PLATELET-LENFOSİT ORANLARININ HASTA PROGNOZUNA ETKİSİ

Öz

Amaç: Bu
çalışmanın amacı acil servise Kronik Obstrüktik Akciğer Hastalığı (KOAH)
alevlenme ile başvuran hastaların prognozunu öngörmede Nötrofil-lenfosit oranı
(NLO) ve Platelet-lenfosit oranının (PLO) etkinliğinin araştırılmasıdır.

Gereç ve Yöntem: Çalışma retrospektif vaka kontrol
çalışması olarak tasarlanmıştır. 1 Ocak 2016 ile 31 Aralık 2016 tarihleri
arasında acil servise KOAH alevlenme ile başvuran tüm hastalar tarandı. Acil
servisten taburcu olan veya servis yatışı yapılan hastalar iyi klinik sonlanım
grubu olarak sınıflandırıldı (Grup 1). Entübe olan, yoğun bakım ihtiyacı olan
ya da eksitus olan hastalarsa kötü klinik sonlanım grubu (Grup 2) olarak kabul
edildi. Grup 1 ve 2 arasında NLO ve PLO açısından anlamlı fark olup olmadığına
bakıldı. Ayrıca bu parametrelerin tek başlarına 30 günlük mortaliteye olan
etkileri de araştırıldı.

Bulgular: Çalışmaya
toplam 1060 hasta dahil edildi. Tüm hastaların laboratuvar değerlerine bakıldığında
hemoglobin, lökosit, nötrofil, platelet ve lenfosit ortanca değerleri sırasıyla
12.9 g/dL (11.50-14.20), 10.9 x 10³/µL (8.42-14.60), 7.87 x 10³/µL
(5.60-11.18), 252 x 10³/µL (197.25-311), 1.75 x 10³/µL
(1.15-2.47). Yine tüm hastalardaki ortanca NLO ve PLO ortanca değerleri de
sırasıyla 4.54 (2.64-8.15) ve 142.08 (98,20-221.03) olarak hesaplanmıştır.
Hastalar iyi ve kötü kritik sonlanımlarına göre gruplandırıldıklarında kötü
prognoz ile hem NLO hem de PLO arasında istatistiksel anlamlı ilişki
bulunmamıştır (sırasıyla p=0.1; 0.4). Hastaların 30 günlük mortalite
durumlarına bakıldığında da kötü prognoz ile hem NLO hem de PLO arasında
istatistiksel anlamlı ilişki bulunmamıştır (sırasıyla p=0.7; 0.6).

Sonuç: Acil
servise KOAH alevlenme ile başvuran hastalarda NLO ve PLO düzeyleri ile kötü
prognoz arasında anlamlı ilişki tespit edilememiş olup bu parametreler prognoz
belirteçleri olarak kullanmaya uygun değildir.

Anahtar Kelimeler

kronik obstrüktif akciğer hastalığı, prognoz, mortalite

Kaynakça

• 1. Akkuş Y, Yılmaz Karabulutlu E, Yağcı S. Kronik obstrüktif akciğer hastalarında (KOAH) anksiyete ve depresyonun bilişsel duruma etkisi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2016(18):94-100.
• 2. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2010;105(2):186-91.
• 3. Can E, Hamilcikan Ş, Can C. The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis. J Pediatr Hematol Oncol. 2018;40(4):e229-e232. doi: 10.1097/MPH.0000000000001059.
• 4. Wu S, Wan Q, Xu R, Zhu X, He H, Zhao X. Systematic review and meta-analysis of the prognostic value of preoperative platelet-to-lymphocyte ratio in patients with urothelial carcinoma. Oncotarget. 2017;8(53):91694-702.
• 5. Acarturk Tuncay E, Karakurt Z, Aksoy E, Gungor S, Ciftaslan N, Irmak İ, et al. Eosinophilic and non-eosinophilic COPD patients with chronic respiratory failure: neutrophil-to-lymphocyte ratio as an exacerbation marker. Int J Chron Obstruct Pulmon Dis. 2017;12:3361-70.
• 6. Yao C, Liu X, Tang Z. Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD. Int J Chron Obstruct Pulmon Dis. 2017;12:2285-90.
• 7. Tanrıverdi H, Ornek T, Erboy F, Altınsoy B, Uygur F, Atalay F et al. Comparison of diagnostic values of procalcitonin, C-reactive protein and blood neutrophil/lymphocyte ratio levels in predicting bacterial infection in hospitalized patients with acute exacerbations of COPD. Wien Klin Wochenschr. 2015;127(19-20):756-63.
• 8. Farah R, Ibrahim R, Nassar M, Najib D, Zivony Y, Eshel E. The neutrophil/lymphocyte ratio is a better addition to C-reactive protein than CD64 index as a marker for infection in COPD. Panminerva Med. 2017;59(3):203-9.
• 9. Komura N, Mabuchi S, Yokoi E, Kozasa K, Kuroda H, Sasano T et al. Comparison of clinical utility between neutrophil count and neutrophil-lymphocyte ratio in patients with ovarian cancer: a single institutional experience and a literature. Int J Clin Oncol. 2018;23(1):104-13. doi: 10.1007/s10147-017-1180-4.
• 10. Min GT, Li YM, Yao N, Wang J, Wang HP, Chen W. The pretreatment neutrophil-lymphocyte ratio may predict prognosis of patients with liver cancer: A systematic review and meta-analysis. Clin Transplant. 2018;32(1): doi: 10.1111/ctr.13151.
• 11. Miyatani K, Saito H, Kono Y, Murakami Y, Kuroda H, Matsunaga T et al. Combined analysis of the pre- and postoperative neutrophil-lymphocyte ratio predicts the outcomes of patients with gastric cancer. Surg Today. 2018;48(3):300-07. doi: 10.1007/s00595-017-1587-6.
• 12. Ozmen S, Timur O, Calik I, Altinkaynak K, Simsek E, Gozcu H et al. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer. Endocr Regul. 2017;51(3):131-6.
• 13. Zhang J, Zhang S, Song Y, He M, Ren Q, Chen C et al. Prognostic role of neutrophil lymphocyte ratio in patients with glioma. Oncotarget. 2017;8(35):59217-24.
• 14. Sonkaya A. Yüksek Nötrofil- Lenfosit Oranının Renal Hücreli Karsinomda Preoperatif ve Postoperatif Dönemde Sağkalıma Etkisi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2017;19(2):73-7.
• 15. Jeon TJ, Park JY. Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis. World J Gastroenterol. 2017;23(21):3883-9.
• 16. Akkurt Z, Türkçü F, Uçmak Yıldırım A, Yüksel H, Yüksel H ve ark. Behçet Hastalığında Artmış Nötrofil/Lenfosit Oranı. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2014;16(3):4-11.
• 17. Omran A, Maaroof A, Saleh MH, Abdelwahab A. Salivary C-reactive protein, mean platelet volume and neutrophil lymphocyte ratio as diagnostic markers for neonatal sepsis. J Pediatr (Rio J). 2018;94(1):82-7.doi:10.1016/j.jped.2017.03.006.
• 18. Zhang J, Ren Q, Song Y, He M, Zeng Y, Liu Z et al. Prognostic role of neutrophil-lymphocyte ratio in patients with acute ischemic stroke. Medicine. 2017;96(45):e8624.
• 19. Zhang J, Cai L, Song Y, Shan B, He M, Ren Q et al. Prognostic role of neutrophil lymphocyte ratio in patients with spontaneous intracerebral hemorrhage. Oncotarget. 2017;8(44):77752-60.
• 20. Chawla A, Huang TL, Ibrahim AM, Hardacre JM, Siegel C, Ammori JB. Pretherapy neutrophil to lymphocyte ratio and platelet to lymphocyte ratio do not predict survival in resectable pancreatic cancer. HPB (Oxford). 2018;20(5):398-404. doi: 10.1016/j.hpb.2017.10.011.
• 21. Emektar E, Corbacıoğlu SK, Dagar S, Uzunosmanoglu H, Safak T, Cevik Y. Prognostic Value of the Neutrophil–Lymphocyte and Platelet–Lymphocyte Ratios in Predicting One-Year Mortality in Patients with Hip Fractures and Aged Over 60 Years. Eurasian J Emerg Med. 2017;16:165-70.