Ömer Faruk ÇİÇEK, Ataberk ATALAY, Recep ÇELİK, Mehmet ÖZDİL, Fatih BONCUK, Adeviye ÜNLÜ, Nisa Nur BABADAĞ, Şükran Aybike AYYILDIZ, Farid SALEHİ, Emre COŞKUNER, Elif YILDIRIM, Zülal CEYLAN

Acil Cerrahi Müdahale Gerektiren Akut Bacak Embolisinde Kırmızı Kan Hücresi Dağılımı-Trombosit Oranının Tanısal Değerinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı, akut bacak embolisi nedeniyle acil cerrahi tedavi uygulanan hastaların başvuru hemogram ölçümlerinden elde edilen kırmızı kan hücresi dağılımı-trombosit oranının (RPR) tanısal bir gösterge olarak önemini, sağlıklı bireylerden oluşan bir kontrol grubuyla karşılaştırarak değerlendirmektir. Yöntemler: Çalışmaya akut alt ekstremite iskemisi nedeniyle femoral embolektomi yapılan 48 hasta dahil edilirken, 49 kişi de kontrol grubu olarak kaydedilmiştir. Demografik, klinik ve laboratuvar verileri iki grup arasında karşılaştırılmıştır. RPR kesme değerini belirlemek için receiver operating characteristic eğrisi kullanılarak eğri altında kalan alan, duyarlılık ve özgüllük hesaplanmıştır. Bulgular: Her iki grubun yaş ve cinsiyet dağılımı benzerdi. Akut emboli nedeniyle ameliyat edilen hastaların başvuru RPR değerleri sağlıklı bireylere kıyasla istatistiksel olarak daha yüksekti (0,0677 (IQR: 0,0547-0,0803) vs. 0,0504 (IQR: 0,0441-0,0572), p<0,001). Akut ekstremite embolisi için eğri altında kalan alan 0,832 olarak belirlenmiş ve 0,566 RPR kesim değerinin akut ekstremite embolisini %72,9 duyarlılık ve %73,5 özgüllükle öngördüğü bulunmuştur (p<0,001). Sonuç: Bulgularımız, RPR'nin akut bacak embolisi için yeni bir tanısal gösterge olarak kullanılabileceğine dair ön kanıtlar sunmaktadır. Bu oranın tek başına tanısal olarak kullanılmasından ziyade, hastanın tıbbi geçmişi ve diğer klinik bulgularla birleştirildiğinde kapsamlı bir değerlendirmesinin, özellikle görüntüleme kaynaklarına sınırlı erişimi olan sağlık hizmeti ortamlarında tanısal süreci hızlandırma potansiyeline sahip olduğu düşünülmektedir.

Anahtar Kelimeler:

akut bacak iskemisi, hemogram, kırmızı kan hücresi dağılımı, trombosit

Assessing the Diagnostic Value of the Red Blood Cell Distribution-To- Platelet Ratio in Acute Leg Embolism Requiring Emergent Surgical Intervention

Background: The objective of this study was to evaluate the significance of the red blood cell distribution-to-platelet ratio (RPR) as a diagnostic indicator, derived from the initial hemogram measurements of patients who underwent emergent surgical treatment for acute leg embolism, by comparing it to a control group of healthy individuals. Methods: The study included 48 patients who underwent femoral embolectomy for acute lower limb ischemia, while an additional 49 individuals were enrolled as a control group. Demographic, clinical, and laboratory data were compared between the two groups. Using the receiver operating characteristic curve to determine the RPR cutoff value, the area under the curve, sensitivity, and specificity were calculated. Results: The age and gender distribution of both groups were comparable. The admission RPR values of patients who underwent surgery for acute embolism were statistically higher compared to healthy individuals (0.0677 (IQR: 0.0547-0.0803) vs. 0.0504 (IQR: 0.0441-0.0572), p<0.001). The area under the curve for acute extremity embolism was determined to be 0.832, and the RPR cut-off value of 0.566 was found to predict acute extremity embolism with a sensitivity of 72.9% and a specificity of 73.5% (p<0.001). Conclusion: Our findings provide preliminary evidence that RPR can be used as a novel diagnostic indicator for acute leg embolism. Rather than being used diagnostically alone, it is thought that a comprehensive evaluation of this ratio, when combined with the patient's medical history and other clinical findings, has the potential to expedite diagnostic process, particularly in healthcare settings with limited access to imaging resources.

Keywords:

acute leg ischemia, hemogram, platelet, red blood cell distribution,

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