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Turkish Journal of Trauma and Emergency Surgery Role of increased immature granulocyte percentage in the early prediction of acute necrotizing pancreatitis [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 2019; 25(2): 177-182 | DOI: 10.14744/tjtes.2019.70679

Role of increased immature granulocyte percentage in the early prediction of acute necrotizing pancreatitis

Yılmaz Ünal, Aziz Mutlu Barlas
Department of General Surgery, Ankara Training and Research Hospital, Ankara-Turkey

BACKGROUND: Acute necrotizing pancreatitis (ANP) is the most severe form of acute pancreatitis (AP), and it has high mortality rates. Therefore, early diagnosis and treatment are of critical importance for the prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in the early prediction of ANP.
METHODS: This retrospective study included 96 adult patients hospitalized with a diagnosis of AP. Demographic data of the patients were recorded. The white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), IG%, C-reactive protein (CRP), and amylase levels were determined. Furthermore, computed abdominal tomography was applied to the patients, and the length of hospital stay was recorded. Patients were divided into two groups as those with acute edematous pancreatitis and ANP, according to the tomography results. The differences between the groups were analyzed statistically.
RESULTS: The WBC count, NLR, CRP, and IG% were significant markers in the prediction of ANP. However, IG% had higher values with regard to the sensitivity, specificity, AUROC, and negative and positive predictive values (100%, 95%, 0.982, 78.9%, and 100%, respectively).
CONCLUSION: An increased IG% is a simple, fast, and effective marker in the early prediction of ANP.

METHODS: This retrospective study was carried out on 96 adult patients who were hospitalized with a diagnosis of acute pancreatitis. Demographic data of the patients were recorded. White blood cell count, neutrophil/lymphocyte ratio, IG%, C-reactive protein and amylase levels were determined. Furthermore computed abdominal tomography was applied to the patients and the length of hospital stay was recorded. The patients were divided into two groups as acute edematous pancreatitis and acute necrotizing pancreatitis according to the tomography results. The differences between the groups were analyzed statistically.
RESULTS: White blood cell count, neutrophil/lymphocyte ratio, C-reactive protein and IG% were significant markers in the prediction of acute necrotizing pancreatitis. However, IG% had higher values of sensitivity, specificity, AUROC, negative and positive predictive values ( 100%, 95%, 0.982, 78.9%, 100%,respectively).
CONCLUSION: Increased IG% is a simple, fast, and effective marker in the early prediction of acute necrotizing pancreatitis.

Keywords: Acute necrotizing pancreatitis, early prediction; immature granulocyte percentage.

Akut nekrotizan pankreatitin erken tahmininde artmış immatür granülosit yüzdesinin rolü

Yılmaz Ünal, Aziz Mutlu Barlas
Ankara Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, Ankara

AMAÇ: Akut nekrotizan pankreatit akut pankreatitin en şiddetli formudur ve yüksek mortalite oranlarına sahiptir. Bu yüzden bu hastalıkta erken tanı ve tedavi prognoz açısından kritik önem taşımaktadır. Bu çalışmanın amacı immatür granülosit yüzdesinin (IG%), akut nekrotizan pankreatitin erken tahminindeki etkinliğini araştırmaktır.
GEREÇ VE YÖNTEM: Bu geriye dönük çalışma akut pankreatit tanısıyla hastaneye yatırılan 96 erişkin hasta üzerinde gerçekleştirildi. Hastaların demografik verileri kaydedildi. Beyaz küre sayısı, nötrofil/lenfosit oranı, IG%, C-reaktif protein ve amilaz düzeyleri tespit edildi. Ayrıca hastalara kontrastlı bilgisayarlı abdominal tomografi incelemesi yapıldı ve hastanede kalış süreleri kaydedildi. Hastalar tomografi sonuçlarına göre akut ödematöz pankreatit ve akut nekrotizan pankreatit olarak iki gruba ayrıldı. Gruplar arasındaki farklılıklar istatistiksel olarak analiz edildi.
BULGULAR: Beyaz küre sayısı, nötrofil/lenfosit oranı, C-rektif protein ve IG% akut nekrotizan pankreatit tahmininde anlamlı belirteçlerdi. Ancak IG%’nin duyarlılık, özgüllük, AUROC, negatif ve pozitif tahmin edici değerleri diğerlerinden daha yüksek idi (sırasıyla, %100, %95, 0.982, %78.9, %100).
TARTIŞMA: Artmış IG% akut nekrotizan pankreatitin erken tahmininde basit, hızlı ve etkili bir belirteçtir.

Anahtar Kelimeler: Akut nekrotizan pankreatit, erken tahmin; immatür granülosit yüzdesi.

Corresponding Author: Yılmaz Ünal, Türkiye
Manuscript Language: English
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