The Usage of Hemogram Parameters for Determining High Centor Score

Öz

Modified Centor Criteria are frequently used to differantiate bacterial-viral tonsilopharyngitis. This scoring system is based on subjective data such as history and physical examination. In this study, the use of hemogram parameters in determining high centor score was investigated. Patients who applied to otolaryngology outpatient clinic with complaint of sore throat between 01/01/2019-31/12/2019 and were diagnosed with acute tonsilopharyngitis were retrospectively scanned. Of these patients, those who were requested to have hemogram at their admission were included in study. Modified centor score was calculated by examining recorded anamnesis and physical examination. Those with a centor score of 4 formed high centor group, while those with a centor score 0 and 1 formed low centor group. It was ensured that there were 30 patients in each group. Two groups were compared in terms of hemogram parameters. Mean white blood cell, neutrophil and monocyte counts were higher in high centor group (10.96±3.49, 7.91±3.43, 1.06±0.34, respectively) than in low centor group (7.94±2.11, 5.10±1.94, 0.66±0.23, respectively). These differences are statistically significant (p<0.001, p<0.001, p<0.001, respectively). Mean MCV and MPV values found in high centor group (84.17±5.48, 9.44±0.99, respectively) were lower than values found in low centor group (86.89±4.49, 10.14±0.78, respectively). These differences are also statistically significant (p=0.008, p= 0.004, respectively). In addition, mean RDW value was found to be higher in high centor group (13.88±1.44) than in low centor group (13.06±0.92, p=0.012). When calculated data were analyzed, mean neutrophil-lymphocyte and monocyte-lymphocyte ratios were found to be higher in high centor group (5.25±4.41, 0.62±0.21, respectively) than in low centor group(3.17±3.04, 0.39±0.24, p<0.001, p<0.001, respectively). Hemogram parameters can be used both to determine high centor score and to differentiate bacterial and viral etiology in acute tonsilopharyngitis. Usage of hemogram parameters together with modified centor scoring system can increase sensitivity and specificity of this scoring system.

Anahtar Kelimeler

• Modified centor score; hemogram; acute tonsilopharyngitis; group A streptococcus

Yüksek Centor Skorunu Belirlemede Hemogram Parametrelerinin Kullanımı

Öz

Modifiye Centor Kriterleri bakteriyel-viral tonsilofaranjit ayrımında sıklıkla kullanılmaktadır. Bu puanlama sistemi anamnez ve fizik muayene bulguları gibi subjektif verilere dayanmaktadır. Bu çalışmada yüksek centor skorunu belirlemede hemogram parametrelerinin kullanımı araştırılmıştır. 01/01/2019-31/12/2019 tarihleri arasında boğaz ağrısı şikayeti ile kulak burun boğaz polikliniğine başvurmuş ve akut tonsilofaranjit tanısı alan hastalar retrospektif olarak tarandı. Bu hastalardan bu başvurularında hemogram tetkiki istenmiş olanlar çalışmaya dahil edildi. Tüm hastaların kayıtlı anamnez ve fizik muayene bulguları incelenerek modifiye centor skoru hesaplandı. Centor skoru 4 olanlar yüksek centor grubunu oluştururken, centor skoru 0 ve 1 olanlar düşük centor grubunu oluşturdu. Herbir grupta 30 hastanın olması sağlandı. İki grup hemogram parametreleri açısından karşılaştırıldı. Ortalama beyaz küre sayısı, nötrofil sayısı, monosit sayısı yüksek centor grubunda (10.96±3.49, 7.91±3.43, 1.06±0.34, sırasıyla) düşük centor grubundan (7.94±2.11, 5.10±1.94, 0.66±0.23, sırasıyla) daha yüksek saptanmıştır. Bu farklar istatistiksel olarak anlamlıdır (p<0.001, p<0.001, p<0.001,sırasıyla). Yüksek centor grubunda saptanan ortalama MCV ve MPV değerleri (84.17±5.48, 9.44±0.99, sırasıyla) düşük centor grubunda saptanan değerlerden (86.89±4.49, 10.14±0.78, sırasıyla) daha düşüktür. Bu farklar da istatistiksel olarak anlamlıdır (p=0.008, p= 0.004, sırasıyla). Ayrıca ortalama RDW değeri yüksek centor grubunda (13.88±1.44) düşük centor grubuna göre (13.06±0.92) daha yüksek bulunmuştur (p=0.012). Hesaplanan veriler incelendiğinde ortalama nötrofil-lenfosit oranı ve ortalama monosit-lenfosit oranı yüksek centor grubunda (5.25±4.41, 0.62±0.21, sırasıyla) düşük centor grubuna göre (3.17±3.04, 0.39±0.24, sırasıyla) daha yüksek saptanmıştır (p<0.001, p<0.001, sırasıyla). Hemogram parametreleri hem yüksek centor skorunu belirlemede hem de akut tonsilofaranjit etiyolojisinde bakteriyel-viral ayrımını yapmakta kullanılabilir. Hemogram parametrelerinin modifiye centor puanlama sistemiyle birlikte kullanımı bu puanlama sisteminin duyarlılık ve özgüllüğünü arttırabilir.

Anahtar Kelimeler

• Modifiye centor skoru
• hemogram
• akut tonsilofaranjit
• grup A streptokok

Kaynakça

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