Acil Serviste İnme ve Hematolojik Parametreler Arasındaki İlişki İncelemesi

Amaç: Amacımız dünyada ölüm nedenleri arasında ön sıralarda yer alan iskemik inme ile kolay ulaşılabilir, ucuz ve hızlı bir test olan hematolojik parametrelerin ilişkisini araştırmaktır. Gereç ve Yöntemler: Araştırma tek merkezli, retrospektif olup Medipol Mega Üniversitesi Hastanesi Acil Servisine başvuran 18 yaş ve üzeri akut iskemik inme ve geçici iskemik atak (GİA) tanısı alan hastalar dahil edildi. Hastaların hematolojik parametreleri ile TOAST sınıflamasına göre inme alt grupları, acil serviste klinik sonlanma durumları ve yatış süreleri değerlendirildi. Hematolojik parametrelerin yoğun bakım ünitesine (YBÜ) yatış durumunu öngörmedeki etkinlikleri ROC (Receiver Operating Characteristic) eğrisi kullanılarak karşılaştırıldı. Bulgular: Toplam 152 hastanın 97’si (%63,8) erkek ve 55’i (%36,2) kadındı. Hastaların yaş ortalaması 64,38 ± 13,69 olarak saptandı. YBÜ’de takip edilen hastaların lökosit (WBC), nötrofil, monosit ve lökositin ortalama platelet hacmine oranı (WMR) servis hastalarına göre istatistiksel olarak yüksek bulundu. Ortalama eritrosit hacminin platelete oranı (MPR) YBÜ’de takip edilen hastalarda servis hastalarına göre daha düşük bulundu. WBC, nötrofil, monosit, ortalama eritrosit hacminin platelete oranı (MPR) ve WMR değerlerinin acil servisten yoğun bakıma yatışı öngörme başarısı istatistiksel olarak anlamlı bulunmuş olup WMR’nin öngörme gücü (AUC: 0,699 ± 0,056) en yüksek saptandı. Sonuç: Sonuç olarak GİA ve iskemik inmeli hastalarda WBC, nötrofil, monosit, WMR ve MPR, YBÜ’ye yatışı öngörmede kullanılabilir.

Anahtar Kelimeler:

Acil servis, hematolojik parametreler, iskemik inme, MPR, WMR

Evaluation of the Relationship Between Hematological Parameters and Stroke in Emergency Department

Aim: Our aim is to investigate the relationship between ischemic stroke, which is one of the leading causes of death in the world, and hematological parameters which are easily accessible, cheap and rapid tests. Material and Methods: The study was a single-center, retrospective and patients aged 18 years and older with acute ischemic stroke and transient ischemic attack (TIA) who applied to Medipol Mega University Hospital Emergency Department were included in the study. Hematological parameters of patients were evaluated with stroke subgroups according to TOAST, clinical outcomes and duration of hospitalization. The predictive efficiency of the hematological parameters to the intensive care unit (ICU) admission status was compared using the ROC (Receiver Operating Characteristic). Results: Of the 152, 97 (63.8%) were male and 55 (36.2%) were female. The median age of the patients was 64,38 ± 13,69. Leukocyte (WBC), neutrophil, monocyte and leukocyte to mean platelet volume ratio (WMR) values in ICU patients were statistically higher than the service patients. Mean platelet volume to platelet ratio (MPR) value was lower in the intensive care unit (ICU) than in the service patients. WBC, neutrophil, monocyte, MPR and WMR's predictive efficiencies to admission to ICU from emergency department were found statistically significant and the predictive power of WMR (AUC: 0.699 ± 0.056) was highest. Conclusion: As a result, WBC, neutrophil, monocyte, WMR and MPR can be used to predict ICU admission in patients with transient ischemic attack and ischemic stroke.

Keywords:

Emergency department, hematological parameters, ischemic stroke, MPR, WMR,

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