Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis

BACKGROUND: The aims of this study were to investigate the clinical significance of systemic inflammatory response index (SIRI), systemic inflammation index (SII), prognostic nutritional index (PNI), and Glasgow prognostic score (GPS) in deciding whether to perform cholecystostomy when determining if cholecystostomy is the right choice for acute cholecystitis (AC) patients.
METHODS: Between January 2018 and December 2020, 126 consecutive patients with AC with and without cholecystostomy were retrospectively recruited from the Trakya University in Edirne, Turkey. Group I included AC patients with cholecystostomy and Group II included AC patients without cholecystostomy. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were calculated. The PNI and SII were calculated
RESULTS: There is significant difference between the two groups by the comparison of SIRI, SII, PNI, and GPS values (p<0.001). In Group I, SIRI, SII, and GPS values are higher than the Group II and PNI value in Group I is lower than the Group II. Furthermore, the NLR and PLR ratios in Group I are significantly higher than Group II, and the LMR ratio in Group I is significantly lower than Group II.
CONCLUSION: According to our study, we can say that NLR, PLR, SII, SIRI, and GPS are positive predictors and LMR and PNI are negative predictors for the severity of AC. Therefore, when we decide to treat AC medically, we may prefer the application of chole-cystostomy tube at the beginning of hospitalization by the help of evaluating NLR, PLR, LMR, SIRI, SII, GPS, and PNI values.

Akut kolesistitli hastalarda SIRI, SII, PNI VE GPS deðerlerinin kolesistostomi uygulamasýndaki prediktif rolü

AMAÇ: Akut kolesistitli hastalarda ilk yatýþ esnasýndaki SIRI (Systemic Inflammatory Response Index), SII (Systemic Inflammation Index), PNI (Prognostic Nutritional Index) ve GPS (Glasgow Prognostic Score) deðerlerinin, akut kolesistitli hastlarda kolesistostomi uygulamasý kararýnýn veril-mesindeki klinik deðerini araþtýrmak hedeflenmiþtir.
GEREÇ VE YÖNTEM: Ocak 2018 ile Aralýk 2020 tarihleri arasýnda Trakya Üniversitesi Týp Fakültesi’nde kolesistostomi uygulanmasýndan baðýmsýz olarak akut kolesistit tanýsý almýþ olan 126 ardýþýk hastanýn dosyalarý retrospektif olarak deðerlendirildi. Grup I kolesistostomi uygulanmýþ hastalardan, Grup II ise kolesistostomi uygulanmamýþ akut kolesistit tanýlý hastalardaý içermektedir. Nötrofil/lenfosit oraný (NLR), trombosit/lenfosit oraný (PLR), lenfosit/monosit oraný (LMR), PNI, GPS ve SII deðerleri her iki grup için de hesaplanmýþtýr.
BULGULAR: Ýki grup arasýnda SIRI, SII, PNI ve GPS deðerleri arasýnda anlamlý fark (p<0.001) saptandý. Grup I’de SIRI, SII ve GPS deðerlerinin Grup II ye göre daha yüksek olduðu görülürken, PNI deðerinin is Grup I’de Grup II’ye göre daha düþük olduðu görülmüþtür. Ayrýca NLR ve PLR deðerleri de Grup I’de Grup II’ye göre belirgin þekilde yüksek saptanýrken, LMR deðeri ise Grup I’de Grup II’ye belirgin olarak düþük bulunmuþtur. TARTIÞMA: Yaptýðýmýz çalýþmaya göre akut kolesistitin klinik þiddeti için NLR, PLR, SII, SIRI ve GPS deðerleri pozitif prediktif faktör olarak, LMR ve PNI negatif prediktif faktör olarak deðerlendirilmiþtir. Dolayýsýyla akut kolesistit tanýlý bir hasta medikal tedavi için hastaneye yatýrýldýðýnda bakýlacak olan NLR, PLR, LMR, SII, SIRI, GPS ve PNI deðerleri yardýmýyla hastanýn erken dönemde kolesistostomi ihtiyacý olup olmayacaðý saptanabilir.