Avci A, Avci B S, Donmez Y, Kocer M, Gulen M, Ozer A I, Bulut A, Koc M, Nazik H, Satar S
Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey.
Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey.
Niger J Clin Pract. 2019 May;22(5):598-602. doi: 10.4103/njcp.njcp_540_18.
The aim of this study was to determine the effectiveness of hematological parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cut-off values of strongly predictive values.
The study began with approval of the ethics committee. In total, 1,929 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width, mean platelet volume, and ratio of neutrophils to lymphocytes (NLR) values were determined and recorded. CK-MB and high-sensitive Troponin T values were recorded as cardiac markers. For statistical analysis, "SPSS for Windows Version 21" package program was used.
About 71.7% (n = 1384) of the patients were male and 28.3% (n = 545) of the patients were female. About 92.5% of the patients (n = 1785) were discharged from the hospital, whereas the remaining 144 patients (7.5%) were exitus in the hospital. When the efficacy of hematological parameters and cardiac markers in predicting mortality was examined by receiver operating charecteristics analysis, NLR was found to be the strongest predictor (area under the curve [AUC], 0.772, standard deviation [SD] = 0.022, 95% confidence interval [CI]). It was found that the WBC value came in second place after NLR as a strong predictor of mortality (AUC, 0.749, SD = 0.024, % 95 CI).
The use of predictors for the prediction of mortality for ST elevation myocardial infarction patients is of great importance for faster implementation of treatment modalities. We found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.
本研究旨在确定急诊室入院时所测血液学参数对预测院内死亡率的有效性，并确定具有强预测价值的临界值。
本研究经伦理委员会批准。共纳入1929例年龄超过18岁且可获取日期的患者。从血常规参数中确定并记录白细胞（WBC）、红细胞分布宽度、平均血小板体积以及中性粒细胞与淋巴细胞比值（NLR）值。记录肌酸激酶同工酶（CK-MB）和高敏肌钙蛋白T值作为心脏标志物。采用“SPSS for Windows Version 21”软件包程序进行统计分析。
约71.7%（n = 1384）的患者为男性，28.3%（n = 545）的患者为女性。约92.5%的患者（n = 1785）出院，其余144例患者（7.5%）在院内死亡。通过受试者工作特征分析检验血液学参数和心脏标志物预测死亡率的效能时，发现NLR是最强的预测指标（曲线下面积[AUC]为0.772，标准差[SD]=0.022，95%置信区间[CI]）。发现WBC值作为死亡率的强预测指标仅次于NLR，位居第二（AUC为0.749，SD = 0.024，95% CI）。
对于ST段抬高型心肌梗死患者，使用预测指标预测死亡率对于更快实施治疗方式非常重要。我们发现通过简单方法获得的WBC值尤其是NLR值可作为有力的预测指标。
