A. Erkin BOZDEMİR, Burcu BARUTÇUOĞLU, Ceyda KABAROĞLU, H.Saygın DEMİREL, Sara HABİF, Mehmet UYAR, Oya BAYINDIR, Dilek ÖZMEN, Ali Reşat MORAL

Çekirdekli eritrositlerin hastane ölümlerinde risk belirleyici rolü

Amaç: Çekirdekli eritrositler (NRBC) sağlıklı erişkinlerde dolaşımda bulunmayan immatür eritrositler olup, ağır hastalık durumlarında saptanmaları, artmış mortalite ve kötü prognoz ile ilişkilendirilmektedir. Bu çalışmada retrospektif olarak NRBC varlığının mortalite ile ilişkisinin araştırılması amaçlanmıştır. Yöntem: Hastanede yatan hastalardan 1 yıl süresince laboratuvara gelen 93833 örnekte (39522 hasta) çekirdekli eritrosit varlığı sorgulandı. Ayrıca, yoğun bakımda yatan 757 hastanın sonuçları retrospektif olarak incelendi. Bu olgulardaki çekirdekli eritrosit düzeyleri ve organ işlev bozuklukları ile ilişkili diğer laboratuvar parametreleri lökosit, trombosit, hemoglobin, CRP, düzeyleri, mortalite durumuna göre karşılaştırıldı. Bulgular: 93833 örneğin 4209’unda (% 4.49), 39522 hastanın 2125’inde (% 5.38) tam kan sayımında dolaşımda NRBC varlığı saptandı. Yoğun bakımda yatan ve ölüm ile sonuçlanan olgularda, hayatta kalan olgulara kıyasla, NRBC, lökosit ve CRP istatistiksel olarak anlamlı derecede yüksek, trombosit ve hemoglobin ise anlamlı düşük bulundu. Sonuç: Yoğun bakım hastalarında saptanan çekirdekli eritrositlerin mortalite ile ilişkisi tam olarak aydınlatılamamıştır. Ancak, çeşitli yayınlarda çekirdekli eritrosit varlığının şiddetli enfeksiyon, hipoksi, akut ve kronik anemi ile ilişkili olduğu bildirilmektedir. Bulgularımız, yoğun bakım hastalarında, çekirdekli eritrositler ile mortalite arasında bir ilişki olduğunu desteklemektedir. Ölümden önce prognostik gösterge olabilecek dolaşımdaki çekirdekli eritrositlerin yüksek riskli hastaları ayırt etmedeki rolü, daha kapsamlı çalışmalarla incelenmelidir.

Indicative role of nucleated red blood cells on inhospital mortality risk

Objective: Nucleated red blood cells (NRBCs) are not present in circulation of healthy adults and NRBCs in severe disease states are frequently correlated with poor prognosis and mortality. Here we aimed to investigate relationship between circulatory NRBCs and mortality retrospectively. Methods: NRBC counts were determined in 93833 samples from 39522 inpatients in a hospital along a year. Results of 757 inpatients of ICU of a hospital were analyzed retrospectively. NRBC, leukocyte, platelet counts and CRP levels of patients who died were compared with survivors’. Results: NRBC was determined in 4209 (4.49%) of 93833 samples, 2125 (5.38%) of 39522 inpatients. NRBC, leukocyte counts and CRP levels were found significantly higher and platelet count and hemoglobin levels were found significantly lower in the cases resulted with death compared with the survivors. Conclusion: Prognostic significance of NRBC detection of ICU patients is not understood yet. But its correlation with severe infections, hypoxia, acute and chronic anemia were reported. Our results support a relationship with NRBC detection and mortality. Further studies are needed to clarify the role of NRBC screening as an early mortality indicator determining the cases at high risk of dying.

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