Yoğun bakım ünitesindeki sepsis hastalarının klinik sonuçlarını tahmin etmede hangi hemogramdan türetilmiş indeksler yararlı olabilir?

Year 2021, Volume: 46 Issue: 2, 532 - 539, 30.06.2021

Esra Çakır , Işıl Özkoçak Turan

https://doi.org/10.17826/cumj.856741

Cited By: 9

Abstract

Amaç: Çalışmamızın amacı, yoğun bakım ünitesinde (YBÜ) sepsis nedeniyle yatan hastalarda nötrofil lenfosit oranı (NLO), monosit lenfosit oranı (MLO) ve trombosit lenfosit oranı (TLO mortaliteyi belirlemedeki prognostik değerini araştırmaktır.
Gereç ve Yöntem: Çalışmamızda, Şubat 2017 – Nisan 2018 tarihleri arasında YBÜ’de yatan tüm sepsisli hastalar retrospektif olarak değerlendirilmiştir. Hastaların demografik ve klinik özelliklerine ek olarak tam kan sayımı parametreleri kayıt edildi. Mortalite olan ve olmayan sepsisli hastaların başlıca NLO, MLO ve TLO sonuçları olmak üzere demografik ve klinik özellikleri ile diğer laboratuvar sonuçları karşılaştırıldı.
Bulgular: Çalışmaya 411 hasta dahil edildi. Sepsisli hastaların %55,7’si (229/411) öldü ve %44,3 hasta (182/411) sağ taburcu edildi. Mortalite olan grupta yaşayan gruba göre NLO, MLO ve TLO daha yüksek bulundu. Sepsisli hastalarda mortalite tahmini için eşik NLO için ≥9,2, MLO için ≥0,8, TLO için ≥187,3 olarak bulundu. Nötrofil lenfosit oranı için eğri altında kalan alana (AUC) değeri 0,825, MLO için AUC değeri 0,835 ve TLO için AUC değeri 0,720 olarak bulundu.
Sonuç: Yoğun bakım ünitesinde yatan sepsis hastalarında yüksek NLO, MLO ve TLO değerleri mortalite ile ilişkili olup, üç oran arasından mortalite göstergesi için en anlamlı parametre AUC değeri en yüksek olan MLO olarak bulundu.

Keywords

Nötrofil lenfosit oranı, monosit lenfosit oranı, trombosit lenfosit oranı, sepsis, yoğun bakım ünitesi, mortalite

Supporting Institution

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Thanks

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Which hemogram-derived indices might be useful in predicting the clinical outcomes of sepsis patients in the intensive care unit?

Abstract

Purpose: The aim of our study is to investigate the prognostic value of Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in determining mortality in patients hospitalized for intensive care unit (ICU) sepsis.
Materials and Methods: This study retrospectively evaluates all patients hospitalized with sepsis in our ICU between February 2017 and April 2018. In addition to the demographic and clinical characteristics of the patients, complete blood count parameters were also recorded. Demographic and clinical characteristics, mainly NLR, MLR and PLR results, and other laboratory results of patients with sepsis were compared between the ones with and without mortality.
Results: Four hundred and eleven patients were included in the study. 55.7% (229/411) of patients with sepsis died and 44.3% (182/411) were discharged alive. NLR, MLR and PLR were higher in the group with mortality compared to the survivor group. The cut-off value for predicting mortality in patients with sepsis was 9.2 for NLR, ≥0.8 for MLR, and ≥187.3 for PLR. The area under the curve (AUC) value for NLR was 0.825, the AUC value for MLR 0.835 and the AUC value for PLR was 0.720.
Conclusion: High NLR, MLR and PLR values are associated with mortality in sepsis patients hospitalized in ICU, and the most significant parameter for mortality indicator among the three rates was found to be MLR with the highest AUC value.

Keywords

neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to lymphocyte ratio, sepsis, intensive care unit

Project Number

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