Can Neutrophil Lymphocyte Ratio Predict the Thrombus Localization in Patient with Acute Pulmonary Embolism?

Amaç: Acil serviste sıklıkla görülen akut pulmoner emboli (PE) hayatı tehdit edici bir hastalıktır. Bu çalışmanın amacı, nötrofil lenfosit oranı (NLR) dahil olmak üzere trombüs lokalizasyonunun beyaz kan hücresi (WBC) alt tipleri ile ilişkilerini belirlemektir. Materyal-Metot: 1 Ocak 2017 - 30 Haziran 2018 tarihleri arasında başvuran akut PE tanısı alan hastaların verilerini retrospektif olarak inceledik. Eşlik eden hastalıklar, risk faktörleri, klinik, laboratuvar ve radyolojik bulgular değerlendirildi. Bulgular: Hastaların yaş ortalaması 63,40 ± 17,11 idi ve hastların 119'u (% 53,1) kadındı. En sık görülen şikayet dispne (% 62,5), en sık eşlik eden hastalık kronik obstrüktif akciğer hastalığı (% 30,4) ve immobilizasyon (% 21,4) en sık görülen risk faktörü idi. Trombüs çoğunlukla bilateral pulmoner arterde (PA) (% 45,9) idi. Hastaların % 46,4'ünde trombüs, lober PA'da lokalize edildi. Ana PA'da trombüs olan hastalarda ortalama WBC, nötrofil, trombosit dağılım genişliği ve NLR, daha distal PA dallarında trombüs olanlara göre daha yüksekti. Hassasiyeti ve özgüllüğü en yüksek olan parametre NLR olarak bulundu. Sonuç: Yüksek NLR, PE'li hastalarda proksimal lokalize trombüs ile bağımsız olarak ilişkilidir.

Anahtar Kelimeler:

Pulmoner emboli, nötrofil lenfosit oranı

Can Neutrophil Lymphocyte Ratio Predict the Thrombus Localization in Patient with Acute Pulmonary Embolism?

Objective: Acute pulmonary embolism (PE), often seen in the emergency department, is a life threatening disease. The aim of this study was to determine the associations of thrombus localization with white blood cell (WBC) subtypes, including the neutrophil lymphocyte ratio (NLR).Material-Method:We retrospectively analysed the data of patients who were diagnosed with acute PE admitted from 1 January 2017 to 30 June 2018. The accompanying disorders, risk factors, clinical, laboratory and radiological findings were retrospectively evaluated.Results: The mean age of the patients was 63.40±17.11 years and 119 (53.1%) patients were female. The most frequent complaint was dyspnea (62.5%), most frequent coexisting disease was chronic obstructive pulmonary disease (30.4%), immobilization (21.4%) was the most frequently seen risk factor. Thrombus was mostly in bilateral pulmonary artery (PA) (45.9%). In 46.4% of the patients, the thrombus was localized to the lobar PA. The mean WBC, neutrophil, platelet distribution width and NLR in the patients with thrombus in the main PA were higher than those in the patients with thrombus in more distal PA branches. The parameter with the highest sensitivity and specificity was found as NLR. Conclusions: High NLR is independently associated with proximally localized thrombus in patients with PE.

Keywords:

Pulmonary embolism, neutrophil lymphocyte ratio,

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