Diagnostic Efficiency of Inflammatory Prognostic Index on Pain Scoring for Degenerated Intervertebral Disc

Abstract

Aim: Inflammatory Prognostic Index (IPI), calculated via Albumin, CRP and Neutrophil-Lymphocyte Ratio (NLR), is used in the inflammation related diseases. The study focused the efficacy and predictive effect of the IPI in terms of Visual Analog Scales (VAS) for interpretation of back and leg pain. Materials and Methods: This multicenter retrospective clinical study was performed by the hospital records of the Degenerated Intervertebral Disc (DIVD) treated between January 2020 and February 2022. IPI value was calculated by the formula of “CRPxNLR/Albumin”. Results: There was a significant difference between VAS-B (2.38±1.74; p=0.0001) and VAS-L (7.09±1.44; p=0.00017) in the comparison of paired VAS values before and after the surgery. Similar change occurred within walking distance after surgery. According to the correlation analysis of the IPI index with DIVD pain scoring, VAS-B(r=0.391; p=0.00017) and delta VAS-B (r=0.422; p=0,00004) showed a positive correlation with the IPI. In the ROC analysis for the diagnostic value of the IPI, the cut-off value of VAS-L above 0.184 showed a diagnostic value as 78.9% sensitivity and 64.3% specificity (UAC:0.702; p:0.003; CI%95: 0.581-0.815). Conclusion: We showed a strong relationship between IPI and pain scoring of DIVD. The diagnostic value of IPI with VAS-L was very important and can be used by physicians for pain follow-up of DIVD.

Keywords

• Disc Hernia
• Inflammatory Prognostic Index
• Pain Scoring

Dejenere Intervertebral Disk için Ağrı Skorlamasında İnflamatuar Prognostik İndeksin Tanısal Etkinliği

Öz

Amaç: Albümin, CRP ve Nötrofil-Lenfosit Oranı (NLR) ile hesaplanan İnflamatuvar Prognostik İndeks (IPI), inflamasyona bağlı hastalıklarda kullanılmaktadır. Çalışmamız, sırt ve bacak ağrısının yorumlanması için Görsel Analog Ölçekler (VAS) açısından IPI’nin etkinliğine ve öngörücü etkisine odaklandı. Materyal ve Metot: Bu çok merkezli retrospektif klinik çalışma, Ocak 2020 ile Şubat 2022 arasında tedavi edilen Dejenere Intervertebral Disk (DIVD) hastalarının hastane kayıtları üzerinden yürütülmüştür. IPI değeri “CRPxNLR/Albumin” formülü ile hesaplanmıştır. Bulgular: Ameliyat öncesi ve sonrası ikili VAS değerleri karşılaştırıldığında, VAS-B (2.38±1.74; p=0.0001) ve VAS-L (7.09±1.44; p=0.00017) arasında anlamlı fark tespit edildi. Ameliyattan sonra yürüme mesafesinde de benzer bir değişiklik meydana geldi. IPI indeksinin DIVD ağrı skorlaması ile korelasyon analizine göre, VAS-B (r=0,391; p=0,00017) ve delta VAS-B (r=0,422; p=0,00004) ile IPI değeri pozitif korelasyon gösterdi. IPI’nin tanısal değeri için yapılan ROC analizinde, VAS-L’nin 0,184’ün üzerindeki kesim değeri, %78,9 duyarlılık ve %64,3 özgüllük olarak tanısal değer göstermiştir (UAC:0.702; s:0,003; CI %95: 0.581-0.815). Sonuç: IPI ile DIVD’nin ağrı skorlaması arasında güçlü bir ilişki olduğunu gösterdik. VAS-L ile IPI’nin tanı değeri çok önemliydi ve doktorlar tarafından DIVD’nin ağrı takibinde kullanılabileceğini düşünmekteyiz.

Kaynakça

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