Ulus Travma Acil Cerrahi Derg. 2019; 25(5): 453-460 | DOI: 10.5505/tjtes.2018.69857

Akut pankreatitte hematolojik parametrelerin deðeri

Akif Yarkaç¹, Ataman Kose², Seyran Bozkurt Babuþ², Fehmi Ates³, Gülhan Orekici Temel⁴, Aydemir Ölmez^5
1Sanlýurfa Bilecik Devlet Acil Týp Fakültesi, Þanlýurfa, Türkiye
²Mersin Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Mersin, Türkiye
³Mersin Üniversitesi Týp Fakültesi Gastroenteroloji Anabilim Dalý, Mersin, Türkiye
⁴Mersin Üniversitesi Týp Fakültesi, Biyoistatistik ve Týbbi Biliþim Bölümü, Mersin, Türkiye
⁵Mersin Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, Mersin, Türkiye

AMAÇ: Akut pankreatit (AP), acil serviste sýk görülen bir enflamatuvar hastalýktýr. Bu çalýþmanýn amacý, acil servise baþvuru sýrasýnda biliyer ve non-biliyer AP’li hafif ve þiddetli AP hastalarýnda C-reaktif protein (CRP) ve hematolojik parametrelerin rolünü deðerlendirmektir.
GEREÇ VE YÖNTEM: Kontrol grubu olarak 100 hasta ve acil serviste AP tanýsý alan 168 hasta çalýþmaya dahil edildi. Kontrol grubunun ve AP hastalarýn demografik bilgileri (yaþ, cinsiyet), amilaz, lipaz, CRP, hematolojik parametreler (beyaz kan hücresi sayýmý [WBC], ortalama trombosit hacmi [MPV], kýrmýzý hücre daðýlým geniþliði [RDW], trombosit sayýmý [PLT], nötrofil-lenfosit oraný [NLR]) kaydedildi ve karþýlaþtýrýldý. Hastalar, AP etiyolojisine göre biliyer ve nonbiliyer grup olarak ayrýldý. Hastalýðýn þiddetine göre, hafif ve þiddetli AP olarak iki grup oluþturuldu, ayný parametreler deðerlendirildi.
BULGULAR: Hasta ve kontrol grubu arasýnda WBC, CRP, NLR, MPV ve PLT deðerleri arasýnda anlamlý fark bulundu (p<0.001). Ranson ve APECHE II skorlamasý WBC, CRP ve NLR ile korele idi. Hafif ve þiddetli AP gruplarý arasýnda, hastanede yatýþ süresi, CRP, WBC ve NLR deðerleri arasýnda istatistiksel olarak anlamlý bir fark vardý (CRP için p=0.003, diðerleri için p<0.001). Ciddi AP’de NLR’nin kestirim deðeri 8.05, sensitivite %93.48, spesifite %86.89 ve AUC: 0.937 olarak bulundu (p<0.001).
TARTIÞMA: Beyaz kan hücresi sayýmý, CRP ve NLR gibi parametrelerin acil serviste diðer diagnostik ve prognostik araçlarla birlikte kullanýlmasý, baþvuru ve prognoz sýrasýnda klinisyenlere kolaylýk saðlayabilir.

Anahtar Kelimeler: Akut pankreatit, kýrmýzý hücre daðýlým geniþliði; nötrofil-lenfosit oraný; ortalama trombosit hacmi; trombosit sayýsý.

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The value of hematological parameters in acute pancreatitis

Akif Yarkaç¹, Ataman Kose², Seyran Bozkurt Babuþ², Fehmi Ates³, Gülhan Orekici Temel⁴, Aydemir Ölmez^5
1Þanlýurfa Bilecik State Hospi̇tal Department of Emergency Medicine, Þanlýurfa-Turkey
²Department of Emergency Medicine, Mersin University Faculty of Medicine, Mersin-Turkey
³Department of Gastroenterology, Mersin University Faculty of Medicine, Mersin-Turkey
⁴Department of Biostatistics and Medical Informaticis, Mersin University Faculty of Medicine, Mersin-Turkey
⁵Department of General Surgery, Mersin University Faculty of Medicine, Mersin-Turkey

BACKGROUND: Acute pancreatitis (AP) is a common inflammatory disease in the emergency department (ED). This study aims to assess the role of CRP and hematologic parameters in mild/severe AP patients and biliary/nonbiliary AP at the time of admission to the ED.
METHODS: 168 patients who were diagnosed as AP in the ED, and as a control group, 100 patients were included in this study. At the time of application to the ED, the demographic information (age, sex) and the amylase, lipase, CRP, hematological parameters (WBC, MPV, RDW, PLT, NLR) of all patients and the control group were recorded and compared. According to the etiology of the patients, the patients were divided into biliary and nonbilary AP groups and according to the severity, they were divided into mild and severe AP groups, then, the same parameters were evaluated.
RESULTS: Significant differences were found out between WBC, CRP, NLR, MPV and PLT values between patient and the control group (p<0.001). The length of hospitalization and the parameters were not significant between the biliary and the nonbiliary group. Ranson and APACHE II scores were correlated with WBC, CRP and NLR. There was a statistically significant difference between the mild and severe AP groups in terms of duration of the hospital stay, CRP, WBC and NLR values (p=0.003 for CRP, p<0.001 for the others). In severe AP, the cut-off value of NLR was found to be 8.05, sensitivity %93.48, specificity %86.89 and AUC 0.937 (p<0.001).
CONCLUSION: The use of parameters, such as WBC, CRP, and NLR, in combination with other diagnostic and prognostic tools in emergency service can provide convenience to clinicians at the time of admission and prognosis.

Keywords: Acute pancreatitis, mean platelet volume, neutrophil-to-lymphocyte ratio; platelet count; red cell distribution width.

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