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急诊科中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值与住院时间和死亡率的关系

The Relationship Between Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios With Hospital Stays and Mortality in the Emergency Department.

作者信息

Cifci Mustafa, Halhalli Huseyin C

机构信息

Emergency Medicine, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, TUR.

出版信息

Cureus. 2020 Dec 20;12(12):e12179. doi: 10.7759/cureus.12179.

Abstract

Background Most acute pancreatitis scoring is made in the first 48-72 hours or later. Like many inflammatory processes, Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can be useful in showing the severity and extent of inflammation in acute pancreatitis. Our study aimed to evaluate whether these rates affect mortality according to the NLR and PLR values ​​of patients diagnosed with acute pancreatitis by examining the blood samples taken within the first hour after admission to the emergency department rates are useful in predicting the length of stay. Methods In our retrospective study, 557 patients applied to our clinic for 4.5 years, whose amylase and lipase values ​​were higher than two times the cut-off value in blood tests and whose CT imaging was compatible with acute pancreatitis were included in the study. Results The median length of hospitalization of the patients was 4.0 (3.0-6.0) days. Gallstones were detected in 320 (57.5%) patients. Mortality of less than a year was observed in 45 (8.1%) of the study population. Eighteen of the patients (3.2%) showed the need for follow-up in the intensive care unit. A statistically significant relationship was found between mortality and variables hematocrit (HCT), red cell distribution width (RDW),c-reactive protein CRP), glucose, urea, potassium, albumin, PLR, and NLR (p <0.05). A statistically significant correlation was observed between RDW, NLR, glucose, and CRP levels in the two groups divided according to the median value of 4 days we found on hospitalization (p <0.05). According to the graphics and test results obtained by ROC analysis, the mortality status can be predicted at a statistically significant level with PLR and NLR diagnostic tests (p <0.05). Conclusion High levels of NLR, PLR, RDW, glucose, CRP, urea, potassium, low albumin and hematocrit values ​​at the first admission in the Emergency Service seem to be associated with increased 1-year mortality in acute pancreatitis.

摘要

背景

大多数急性胰腺炎评分在最初48 - 72小时或更晚进行。与许多炎症过程一样,中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)有助于显示急性胰腺炎炎症的严重程度和范围。我们的研究旨在通过检查急诊科入院后第一小时内采集的血样,根据急性胰腺炎患者的NLR和PLR值来评估这些比率是否影响死亡率,这些比率有助于预测住院时间。方法:在我们的回顾性研究中,纳入了4.5年间到我们诊所就诊的557例患者,这些患者血液检查中的淀粉酶和脂肪酶值高于临界值两倍,且CT影像与急性胰腺炎相符。结果:患者的中位住院时间为4.0(3.0 - 6.0)天。320例(57.5%)患者检测出胆结石。研究人群中45例(8.1%)观察到不到一年的死亡率。18例患者(3.2%)显示需要在重症监护病房进行随访。发现死亡率与血细胞比容(HCT)、红细胞分布宽度(RDW)、C反应蛋白(CRP)、葡萄糖、尿素、钾、白蛋白、PLR和NLR等变量之间存在统计学显著关系(p <0.05)。根据我们在住院时发现的4天中位值划分的两组中,RDW、NLR、葡萄糖和CRP水平之间观察到统计学显著相关性(p <0.05)。根据ROC分析获得的图形和测试结果,PLR和NLR诊断测试可以在统计学显著水平预测死亡状态(p <0.05)。结论:急诊服务首次入院时高水平的NLR、PLR、RDW、葡萄糖、CRP、尿素、钾、低白蛋白和血细胞比容值似乎与急性胰腺炎患者1年死亡率增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bac9/7816547/fa45583cdfd2/cureus-0012-00000012179-i01.jpg

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