Yoðun bakýmda yatan acil cerrahi hastalarda C-reaktif protein/albümin oraný ve hematolojik parametrelerin prognozu ön görmedeki etkisi

AMAÇ: Acil cerrahi patolojilerin taný ve tedavisinin saatler içinde yapýlmasý gerekmekte olup, geç kalýnan durumlarda hastanýn prognozu daha da kötüye gidebilmektedir. Bu konuda kolay ve etkili belirteçlere ihtiyaç duyulmaktadýr. Bu çalýþmadaki amacýmýz, yoðun bakýma yatan acil cerrahi hastalarýnda C-reaktif protein (CRP)/albümin oraný ve hematolojik parametrelerin prognozu ön görmede kullanýlabilirliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Çalýþma yoðun bakýmýnda takip edilen hastalarýn dosyalarýnýn geriye dönük olarak taranmasý ile yapýldý. Acil cerrahi sonrasý yatan hastalar ‘acil grubu’ olarak, elektif majör cerrahi sonrasý yatan hastalar ‘kontrol grubu’ olarak alýndý. Hastalarýn demografik özelliklerinin yaný sýra, yoðun bakýmda yatýþ süreleri, mekanik ventilatör ihtiyacýnýn olup olmadýðý, yoðun bakýma yatýþtan önce, ameliyat öncesi kan deðerlerinden platelet/lenfosit (P/L), nötrofil/lenfosit (N/L), CRP/albümin deðerleri kaydedilip her iki grubun deðerleri istatistiksel olarak karþýlaþtýrýldý.
BULGULAR: Çalýþmaya toplam 341 hasta alýndý, bunlarýn 111’i acil (%32.6) (Grup 1), 230’u elektif (%67.4) (Grup 2) olgu idi. Acil ve elektif olgular karþýlaþtýrýldýðýnda, Grup 1’de ortalama CRP/albümin deðeri 49.05 saptanýrken, Grup 2’de 32.8 olarak saptanmýþtýr (p=0.001). N/L deðerleri ise Grup 1’de 11.9, Grup 2’de 9.87 bulunmuþtur (p=0.04). Diðer bir hematolojik parametre olan P/L deðerlerine bakýldýðýnda ise Grup 1’de 272.62 bulunurken, Grup 2’de 229.17 olarak saptanmýþtýr (p=0.03). Hastanede yatýþ günleri Grup 1’de ortalama 13.61 gün iken, Grup 2’de 12.43 gündür. CRP/albümin >40 olduðunda duyarlýlýðý %80.49, seçiciliði ise %67.22 olarak belirlenmiþtir (p<0.001).
TARTIÞMA: CRP/albümin oraný cerrahi olgularýn aciliyetini belirlemede ve mortalitesi hakkýnda öngörüde bulunmada etkili bir belirteç olarak kullanýlabilir.

The effects of C-reactive protein/albumin ratio and hematologic parameters on predicting the prognosis for emergency surgical patients in intensive care

BACKGROUND: Diagnosis and treatment of emergency surgical pathologies should be addressed within hours, and the prognosis of the patient may deteriorate further in cases of delay. Easy and effective markers are needed in this regard. Our aim in this study is to evaluate the CRP/albumin ratio and the usability of hematological parameters in predicting prognosis in emergency surgical patients in intensive care.
METHODS: This study was performed by retrospectively scanning the files of the patients who were followed up in the intensive care unit. Patients hospitalized after emergency surgery were taken as ‘emergency group’ and patients hospitalized after elective major surgery were taken as ‘control group’. In addition to the demographic characteristics of the patients, the length of hospitalization in the intensive care unit, whether there was a need for mechanical ventilation, platelet/lymphocyte (P/L), neutrophil/lymphocyte (N/L), C-reactive protein (CRP)/albumin values were recorded and the values of both groups were compared statistically.
RESULTS: In this study, 341 patients were included, of which 111 were emergency (32.6%) (Group 1), 230 were elective (67.4%) (Group 2) cases. When the emergency and elective cases were compared, the average CRP/albumin value was 49.05 in Group 1 and 32.8 in Group 2 (p=0.001). N/L values were 11.9 in Group 1 and 9.87 in Group 2 (p=0.04). When looking at another hematological parameter, P/L, it was found 272.62 in Group 1 and 229.17 in Group 2 (p=0.03). Hospitalization days were 13.61 days in Group 1, while 12.43 days in Group 2. When CRP/albumin >40, its sensitivity was determined as 80.49% and its selectivity as 67.22% (p<0.001).
CONCLUSION: The CRP/albumin ratio can be used as an effective marker in determining the urgency of surgical cases and predicting mortality.