Karlidag Taner, Bingol Olgun, Sarikaya Baran, Keskin Omer Halit, Durgal Atahan, Ozdemir Guzelali
Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.
Department of Orthopaedic Surgery, Gaziantep City Hospital, Gaziantep, Turkey.
Sci Rep. 2024 Dec 16;14(1):30494. doi: 10.1038/s41598-024-82035-0.
The rationale behind this study was the lack of an accurate predictor to facilitate treatment management and anticipate prognosis in crush syndrome. Our research aimed to investigate the following: (1) Is there a correlation between the ratios of blood cell counts upon admission and the adverse outcomes of crush syndrome? and (2) if such a correlation exists, what are the precise thresholds of blood cell count ratios for predicting these adverse outcomes? In this single-centered and retrospective design study, we analyzed all patients admitted to our hospital after Kahramanmaras Earthquake. The data on length of stay in the ICU and mortality status were obtained using our hospital system. Ratios of blood cell count were calculated and recorded at the time of admission. The NLR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU), and patients who died. (p < 0.001, p < 0.001 and p = 0.001, respectively). The MLR values were significantly increased in patients who underwent amputation and patients who received ICU (p < 0.001 and p = 0.003, respectively). NAR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU), and patients who died (p < 0.001, p < 0.001, and p = 0.002, respectively). In addition, according to binary logistic regression analysis, with a CLR value of > 109.844, the risk of amputation increases 8.188 fold; with a CLR value of > 64.518, the possibility of ICU admission requirement increases 10.117 fold, and with a CLR value of > 116.00, the risk of death increases 5.519 fold. Ratios of blood cell count such as NLR, MLR, NAR, and CLR offer a reasonable prognostic accuracy in predicting adverse outcomes and mortality in patients with crush syndrome. Therefore, for better disaster management in the future, the determination of these values at admission should be used as an adjunct tool for predicting prognosis in patients with crush syndrome.
本研究背后的基本原理是缺乏一种准确的预测指标来促进挤压综合征的治疗管理并预测预后。我们的研究旨在调查以下内容：（1）入院时血细胞计数比值与挤压综合征的不良结局之间是否存在相关性？以及（2）如果存在这种相关性，预测这些不良结局的血细胞计数比值的精确阈值是多少？在这项单中心回顾性设计研究中，我们分析了加济安泰普地震后入住我院的所有患者。使用我院系统获取了在重症监护病房（ICU）的住院时长和死亡状态数据。入院时计算并记录血细胞计数比值。截肢患者、入住重症监护病房（ICU）的患者以及死亡患者入院时的中性粒细胞与淋巴细胞比值（NLR）值显著更高（分别为p < 0.001、p < 0.001和p = 0.001）。接受截肢手术的患者和入住ICU的患者的单核细胞与淋巴细胞比值（MLR）值显著升高（分别为p < 0.001和p = 0.003）。截肢患者、入住重症监护病房（ICU）的患者以及死亡患者入院时的中性粒细胞与嗜酸性粒细胞比值（NAR）值显著更高（分别为p < 0.001、p < 0.001和p = 0.002）。此外，根据二元逻辑回归分析，当淋巴细胞与单核细胞比值（CLR）值> 109.844时，截肢风险增加8.188倍；当CLR值> 64.518时，入住ICU的需求可能性增加10.117倍；当CLR值> 116.00时，死亡风险增加5.519倍。诸如NLR、MLR、NAR和CLR等血细胞计数比值在预测挤压综合征患者的不良结局和死亡率方面具有合理的预后准确性。因此，为了未来更好地进行灾害管理，入院时确定这些值应用作预测挤压综合征患者预后的辅助工具。
