Department of Intensive Care Unite, Aydın State Hospital, Aydın-Turkey.
Department of General Surgery, Aydın State Hospital, Aydın-Turkey.
Ulus Travma Acil Cerrahi Derg. 2021 Jan;27(1):67-72. doi: 10.14744/tjtes.2020.45758.
Diagnosis and treatment of emergency surgical pathologies should be addressed within hours, and the prognosis of the patient may deteriorate further in cases of delay. Easy and effective markers are needed in this regard. Our aim in this study is to evaluate the CRP/albumin ratio and the usability of hematological parameters in predicting prognosis in emergency surgical patients in intensive care.
This study was performed by retrospectively scanning the files of the patients who were followed up in the intensive care unit. Patients hospitalized after emergency surgery were taken as 'emergency group' and patients hospitalized after elective major surgery were taken as 'control group'. In addition to the demographic characteristics of the patients, the length of hospitalization in the intensive care unit, whether there was a need for mechanical ventilation, platelet/lymphocyte (P/L), neutrophil/lymphocyte (N/L), C-reactive protein (CRP)/albumin values were recorded and the values of both groups were compared statistically.
In this study, 341 patients were included, of which 111 were emergency (32.6%) (Group 1), 230 were elective (67.4%) (Group 2) cases. When the emergency and elective cases were compared, the average CRP/albumin value was 49.05 in Group 1 and 32.8 in Group 2 (p=0.001). N/L values were 11.9 in Group 1 and 9.87 in Group 2 (p=0.04). When looking at another hematological parameter, P/L, it was found 272.62 in Group 1 and 229.17 in Group 2 (p=0.03). Hospitalization days were 13.61 days in Group 1, while 12.43 days in Group 2. When CRP/albumin >40, its sensitivity was determined as 80.49% and its selectivity as 67.22% (p<0.001).
The CRP/albumin ratio can be used as an effective marker in determining the urgency of surgical cases and predicting mortality.
急诊外科病理的诊断和治疗应在数小时内完成,否则患者的预后可能会进一步恶化。在这方面需要简单有效的标志物。我们在这项研究中的目的是评估 CRP/白蛋白比值和血液学参数在预测重症监护急诊外科患者预后方面的可用性。
本研究通过回顾性扫描在重症监护病房接受随访的患者的档案进行。将急诊手术后住院的患者视为“急诊组”,将择期大手术后住院的患者视为“对照组”。除了患者的人口统计学特征外,还记录了患者在重症监护病房的住院时间、是否需要机械通气、血小板/淋巴细胞(P/L)、中性粒细胞/淋巴细胞(N/L)、C 反应蛋白(CRP)/白蛋白值,并对两组的数值进行了统计学比较。
本研究共纳入 341 例患者,其中 111 例为急诊(32.6%)(第 1 组),230 例为择期(67.4%)(第 2 组)。在比较急诊和择期病例时,第 1 组的平均 CRP/白蛋白值为 49.05,第 2 组为 32.8(p=0.001)。第 1 组的 N/L 值为 11.9,第 2 组为 9.87(p=0.04)。当观察另一个血液学参数 P/L 时,第 1 组为 272.62,第 2 组为 229.17(p=0.03)。第 1 组的住院天数为 13.61 天,第 2 组为 12.43 天。当 CRP/白蛋白>40 时,其灵敏度为 80.49%,特异性为 67.22%(p<0.001)。
CRP/白蛋白比值可作为确定手术紧迫性和预测死亡率的有效标志物。