ACİL SERVİSE KRONİK OBSTRÜKTİK AKCİĞER HASTALIĞI AKUT ALEVLENMESİ İLE BAŞVURAN HASTALARDA NÖTROFİL-LENFOSİT VE PLATELET-LENFOSİT ORANLARININ HASTA PROGNOZUNA ETKİSİ

Amaç: Bu çalışmanın amacı acil servise Kronik Obstrüktik Akciğer Hastalığı (KOAH) alevlenme ile başvuran hastaların prognozunu öngörmede Nötrofil-lenfosit oranı (NLO) ve Platelet-lenfosit oranının (PLO) etkinliğinin araştırılmasıdır.Gereç ve Yöntem: Çalışma retrospektif vaka kontrol çalışması olarak tasarlanmıştır. 1 Ocak 2016 ile 31 Aralık 2016 tarihleri arasında acil servise KOAH alevlenme ile başvuran tüm hastalar tarandı. Acil servisten taburcu olan veya servis yatışı yapılan hastalar iyi klinik sonlanım grubu olarak sınıflandırıldı (Grup 1). Entübe olan, yoğun bakım ihtiyacı olan ya da eksitus olan hastalarsa kötü klinik sonlanım grubu (Grup 2) olarak kabul edildi. Grup 1 ve 2 arasında NLO ve PLO açısından anlamlı fark olup olmadığına bakıldı. Ayrıca bu parametrelerin tek başlarına 30 günlük mortaliteye olan etkileri de araştırıldı.Bulgular: Çalışmaya toplam 1060 hasta dahil edildi. Tüm hastaların laboratuvar değerlerine bakıldığında hemoglobin, lökosit, nötrofil, platelet ve lenfosit ortanca değerleri sırasıyla 12.9 g/dL (11.50-14.20), 10.9 x 103/µL (8.42-14.60), 7.87 x 103/µL (5.60-11.18), 252 x 103/µL (197.25-311), 1.75 x 103/µL (1.15-2.47). Yine tüm hastalardaki ortanca NLO ve PLO ortanca değerleri de sırasıyla 4.54 (2.64-8.15) ve 142.08 (98,20-221.03) olarak hesaplanmıştır. Hastalar iyi ve kötü kritik sonlanımlarına göre gruplandırıldıklarında kötü prognoz ile hem NLO hem de PLO arasında istatistiksel anlamlı ilişki bulunmamıştır (sırasıyla p=0.1; 0.4). Hastaların 30 günlük mortalite durumlarına bakıldığında da kötü prognoz ile hem NLO hem de PLO arasında istatistiksel anlamlı ilişki bulunmamıştır (sırasıyla p=0.7; 0.6). Sonuç: Acil servise KOAH alevlenme ile başvuran hastalarda NLO ve PLO düzeyleri ile kötü prognoz arasında anlamlı ilişki tespit edilememiş olup bu parametreler prognoz belirteçleri olarak kullanmaya uygun değildir.

Anahtar Kelimeler:

kronik obstrüktif akciğer hastalığı, prognoz, mortalite

Prognostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients Who Admitted to the Emergency Department with Chronic Obstructive Pulmonary Disease Exacerbation

Objective: In this study, we aimed to investigate the prognostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients presenting with chronic obstructive pulmonary disease exacerbation.Material and Methods: This was a retrospective case control study. We searched the patients who admitted to the emergency department with chronic obstructive pulmonary disease exacerbation between 1st January 2016 and 31th December 2016. The patients who were discharged from emergency department or hospitalized in wards were classified as good clinical outcome group (group 1). The patients who were intubated and admitted to intensive care unit or the ones who died were classified as poor clinical outcome group (group 2). We evaluated whether there was a statistically significant difference between the two groups according to the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and whether these parameters effected 30 days mortality.Results: One thousand and sixty patients were included in the study. The hemoglobin levels, leukocyte, neutrophil, platelet and lymphocyte counts of all patients were respectively 12,9 g/dL (11,50-14,20), 10,9 103/µL (8,42-14,60), 7,87 103/µL (5,60-11,18), 252 103/µL (197,25-311), 1,75 103/µL (1,15-2,47). Medians of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of all patients were 4,54 (2,64-8,15) ve 142,08 (98,20-221,03). There were no statistically significant difference between the groups according to the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (respectively p=0,1, p=0,4). There also was not a significant relationship between the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and 30 days mortality. Conclusion: There was no significant relationship between the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and poor prognosis in patients presenting with chronic obstructive pulmonary disease exacerbation. We believe that these parameters are not eligible markers for predicting the prognosis in these patients.

Keywords:

Chronic Obstructive Pulmonary Disease, Prognoses, Mortality,

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