Can the neutrophil to lymphocyte ratio, determined in the whole blood count, be used as a mortality marker in patients with pulmonary thromboembolism ?

Yıl 2020, , 422 - 429, 15.09.2020

Fahrettin Turna Asim Enhoş

https://doi.org/10.31832/smj.747828

Cited By: 1

Öz

Objective: Acute pulmonary thromboembolism (APTE) is one of the life-threatening cardiovascular diseases. Following the diagnosis, it has a broad range of severity and a wide spectrum. Its mortality and morbidity vary depending on its clinical scope and the site of involvement. Neutrophil / lymphocyte ratio (NLR) has previously been studied in many cardiovascular disease processes as an indicator of inflammation and marker of mortality. The aim of our study is to determine the correlation between NLR and the 30-day mortality in APTE.
Materials and Methods: 160 APTE patients who applied to the emergency department of Bagcilar Education and Research Hospital between January 2011 and June 2013 were determined retrospectively and hemogram parameters at the time of application were recorded. It was ensured in the selection of patients that all patients had a final diagnosis supported by computed tomography. APTE patients; It was divided into two groups in terms of those who died (n:28) and survived (n:120) within 30 days. Low, medium and high risk APTE patients in both groups were compared in terms of NLR. The utility of NLR as a marker of mortality was investigated in patients with pulmonary embolism
Results: NLR was significantly higher in the deceased group (11.40 ± 4.24 vs 18.33 ± 9.06, p < 0.001). It had 57 % sensitivity and 89 % specificity for prediction of mortality (Area Under Curve: 0.736, 95% CI: 0.619–0.853, p < 0.001) in patients with pulmonary embolism. In the multivariate logistic regression analysis; NLR was found to be signifant independent predictor of the 30-day mortality (Odds: 1.132 (1.031-1.243, CI 95%), p=0.009).
Conclusion: NLR plays a strong role in determining 30-day mortality in APTE patients.
Key Words: Leukocyte Count; Pulmonary embolism; Mortality

Anahtar Kelimeler

Leukocyte Count;, Pulmonary embolism;, Mortality;

Tam kan sayımında belirlenen nötrofil/lenfosit oranı pulmoner tromboemboli hastalarında mortalite belirteci olarak kullanılabilir mi?

Öz

Amaç: Akut pulmoner tromboemboli (APTE) hayatı tehdit eden kardiyovasküler hastalıklardan biridir. Teşhisi takiben, geniş bir ciddiyet aralığı ve spektrumu vardır. Mortalitesi ve morbiditesi klinik kapsamına ve tutulum yerine bağlı olarak değişir. Nötrofil / lenfosit oranı (NLR) daha önce birçok kardiyovasküler hastalık sürecinde inflamasyon ve mortalite belirteci olarak incelenmiştir. Çalışmamızın amacı, APTE'de NLR ile 30 günlük mortalite arasındaki korelasyonu belirlemektir.
Gereç ve Yöntemler: Ocak 2011 - Haziran 2013 tarihleri arasında Bağcılar Eğitim ve Araştırma Hastanesi acil servisine başvuran hastalardan 160 APTE hastası retrospektif olarak saptandı ve başvuru sırasında hemogram parametreleri kaydedildi. Hasta seçiminde tüm hastaların bilgisayarlı tomografi ile desteklenen kesin tanı alması sağlandı. APTE hastaları; 30 gün içinde ölen (n: 28) ve hayatta kalan (n: 120) olarak iki gruba ayrıldı. Her iki gruptaki düşük, orta ve yüksek riskli APTE hastaları NLR açısından karşılaştırıldı. Pulmoner emboli hastalarında NLR'nin mortalite belirteci olarak kullanımı araştırıldı.
Bulgular: Ölen grupta NLR anlamlı olarak daha yüksekti (11.40 ± 4.24'e karşı 18.33 ± 9.06, p <0.001). Pulmoner emboli hastalarında NLR; mortalite tahmini için % 57 duyarlılığa ve % 89 özgüllüğe (Eğri altındaki alan: 0.736,% 95 CI: 0.619-0.853, p <0.001) sahipti. Çok değişkenli lojistik regresyon analizinde; NLR'nin 30 günlük mortalitenin anlamlı bağımsız prediktörü olduğu bulunmuştur (Odds Oranı: 1.132 (1.031-1.243, GA% 95), p = 0.009).
Sonuç: NLR, APTE hastalarında 30 günlük mortalitenin belirlenmesinde güçlü bir rol oynamaktadır.

Anahtar Kelimeler

Lökosit Sayısı;, Pulmoner Emboli;, Mortalite;

Kaynakça

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