Mustafa Enes DEMİREL, Ufuk Turan Kürşat KORKMAZ, İbrahim DÖNMEZ, Ayşenur ÖZÇELİK, Abdullah KORKMAZ

Stanford Tip A Aort Diseksiyonunda C-Reaktif Protein/Albumin Oranı İle Mii-1 ve Mii-2 İndekslerinin Hastaneye Yatış Süresi ve Mortalite İlişkisi

Amaç: Bu çalışmamızda hastanede yatış ve aort diseksiyonuna bağlı mortalitede C-Reaktif Protein (CRP)/albümin oranı, MII-1 ve MII-2 indeksleri arasındaki ilişkiyi araştırmayı amaçladık. Material and Methot: Acil servisimize akut başlangıçlı, keskin ve saplayıcı göğüs ağrısı ile başvurup Stanford Tip A aort diseksiyonu tanısı alan hastalar çalışmaya dahil edildi. Hastaların yaş ve cinsiyet gibi demografik bilgileri, hemogram parametreleri, oranları, indeksleri, yatış ve mortalite durumları çalışmaya alındı. Taburcu olanlar ve hayatını kaybeden hastalar arasında demografik özellikler, hemogram parametreleri, oranlar ve indeksler karşılaştırıldı. Bulgular: Bu retrospektif çalışmaya, acil servisimize başvuran ve ardından aort disseksiyonu tanısı konan toplam 71 hasta dahil edildi. Hastaların medyan yaşı albümin (r=-0.27, p=0.021), hemoglobin (r=-0.28, p=0.019) ve prognostik nutrisyonel indeks (PNI) (r=-0.31, p=0.008) ile negatif korelasyon gösterdi. Hemoglobin değerleri erkek hastalarda kadınlara göre anlamlı derecede yüksekti. Hastanede kalış süresi median 10 (7-14) gün olarak bulundu. Hemogram parametrelerinin, indekslerin ve hastanede kalış sürelerinin korelasyon analizinde; CRP ve CRP/Albumin oranı hastanede kalış süresi ile pozitif yönde anlamlı olarak korele idi. Sonuç: Bu çalışmanın sonuçları, CRP, CRP/albümin oranı ve hastanede kalış süresi arasında anlamlı bir ilişkiye işaret etmektedir. Bu bilgiler hastalığın erken teşhisi ve tedavisi için hızlı karar verme sürecinde yardımcı olabilir.

The Correlation of C-Reactive Protein/Albumin, Mii-1 and Mii-2 Indexes With Hospitalization and Mortality in Stanford Type A Aortic Dissection

Aim: In this study we aimed to investigate the relationship between C-Reactive Protein (CRP)/albumin ratio, MII-1 and MII-2 indexes in hospitalization and mortality due to aortic dissection. Material and Method: Patients who presented to our emergency department with a sudden-onset, sharp and stabbing chest pain and diagnosed with Stanford type A aortic dissection were included in the study. Patients’ demographics such as age and gender, hemogram parameters, ratios, indexes, hospitalization and mortality status were recorded. Demographic features, hemogram parameters, ratios and indexes were compared between the survivor and exitus patients. Results: A total of 71 patients who presented to the emergency department with sudden-onset stabbing chest pain and subsequently diagnosed with aortic dissection were included in this retrospective study. The median age of the patients was negatively correlated with albumin (r=-0.27, p=0.021), hemoglobin (r=-0.28, p=0.019). Hemoglobin values were significantly higher in male than in female patients. The median length of stay in the hospital was found as 10 (7-14) days. In the correlation analysis of the hemogram parameters, indexes and length of stay in the hospital; CRP and CRP/Albumin ratio were significantly correlated with length of stay in the hospital in positive direction. Conclusion: The results of this study point out a significant correlation between CRP, CRP/albumin ratio and length of stay in hospital. This information might be helpful in rapid decision making process for early diagnosis and treatment of the disease.

Keywords:

C-reactive protein/albumin, Multi Inflammatory Index, aortic dissection, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio,

PDF

___

Ankel F. Aortic dissection. In: Marx JA, Hockberger RS, Walls RM, et al, editors. Rosen’s emergency medicine: concepts and clinical practice. 7th edition. Philadelphia: Mosby Elsevier Publishing; 2010. p. 1088–92. Chapter 83.
Braverman AC. Acute aortic dissection: Clinician update. Circulation. 2010;122(2):184-8.
Alter SM, Eskin B, Allegra JR. Diagnosis of Aortic Dissection in Emergency Department Patients is Rare. West J Emerg Med. 2015;16(5):629-631.
Cantrill SV, Brown MD, Burton JH, Diercks DB, Gemme SR, Gerardo CJ, et al. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients With Suspected Acute Nontraumatic Thoracic Aortic Dissection. Annals of Emergency Medicine. 2015;65(1):32-42.
Hiratazka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/ SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. Circulation 2010; 55(14), e27-e129
Shirakabe A, Hata N, Yokoyama S, et al. Diagnostic score to differentiate acute aortic dissection in the emergency room. Circ J. 2008;72(6), 986-990.
Yildiz S, Kazğan A, Tabara M, Atmaca M: The Relationship Between Impulsivity Level and Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio and Mean Platelet Volume in Individuals Diagnosed with Gambling Disorder. Medical Records, 3(3):177-183.
Sevil, Ergun, Betul Değer Kulaksiz, and Ayla Islamoglu. "Association Between the Inflammatory Parameters and Prognosis of Bell’s Palsy." Northwest Med J. 2021; 1(2): 35-41.
Forrer A, Schoenrath F, Torzewski M, et al. Novel Blood Biomarkers for a Diagnostic Workup of Acute Aortic Dissection. Diagnostics (Basel). 2021;11(4):615.
Gao Y, Li D, Cao Y, Zhu X, Zeng Z, Tang L. Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study. Medicine (Baltimore). 2019;98(6):e14486.
Boyuk F. The role of the multi-inflammatory index as a novel inflammation-related index in the differential diagnosis of massive and non-massive pulmonary embolism. Int J Clin Pract. 2021;75(12):e14966.
Wen D, Zhou XL, Li JJ, Hui RT. Biomarkers in aortic dissection. Clin Chim Acta. 2011;412(9-10):688-695.
Nienaber CA, Clough RE, Sakalihasan N, et al. Aortic dissection. Nat Rev Dis Primers. 2016; 2(1), 1-18.
Vrsalović M, Vrsalović Presečki A. Admission C-reactive protein and outcomes in acute aortic dissection: a systematic review. Croat Med J. 2019;60(4):309-315.
Li JJ, Zhu CG, Yu B, Liu YX, Yu MY. The role of inflammation in coronary artery calcification. Aging Res Rev 2007; 6(4), 263-270.
Komukai K, Shibata T, Mochizuki S. C-reactive protein is related to impaired oxygenation in patients with acute aortic dissection. Int Heart J 2005; 46(5), 795-799.
Mir MA. Aortic dissection in pursuit of a serum marker. Am J Emerg Med 2008; 26(8), 942-945.
Sakakura K, Kubo N, Ako J, et al. Peak C-reactive protein level predicts long-term outcomes in type B acute aortic dissection. Hypertension. 2010;55(2):422-429.
Vrsalovic M, Vucur K, Car B, Krcmar T, Vrsalovic Presecki A. C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function. Croat Med J. 2015;56:351–6.
Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, et al. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol 2015; 22: 803-10.
Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/ albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013; 8: e59321.
Yazar T, Yazar HO. Evaluation of C-reactive Protein/Albumin Ratio According to Stage in Patients with Idiopathic Parkinson Disease. Turk J Neurol 2019;25:123-128.
Demir E, Giden R, Giden ZD. The Relationship Between C-Reactive Protein/Albumin Ratio and Radiological Findings in Patients with COVID-19. J Contemp Med 2021; 11(5): 627-630.
Kahraman S, Dogan AC, Demirci G, et al. The Prognostic Value of C-reactive Protein to Albumin Ratio in Patients with Isolated Degenerative Aortic Valve Stenosis Undergoing Surgical Aortic Valve Replacement. Braz J Cardiovasc Surg. 2020;35(3):299-306.
Casadei Gardini A, Scarpi E, Valgiusti M, Monti M, Ruscelli S, Matteucci L, et al. Prognostic role of a new index (multi inflammatory index) in patients with metastatic colorectal cancer: results from the randomized ITACa trial. Therapeutic Advances in Medical Oncology. 2020;12:1758835920958363.