Nötrofil Lenfosit Oranı Akut Pulmoner Embolili Hastada Trombüs Lokalizasyonunu Tahmin Edebilir mi?

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 yıl idi ve hastaların 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 pulmoner arterlerde (PA) bilateral (n=103) olarak izlendi. Hastaların %46,4’ünde trombüs, lober PA’da lokalize edildi. Ana PA’da trombüs olan hastalarda ortalama beyaz kan hücresi, 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.

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

Objective: Acute pulmonary embolism (PE) is a lifethreateningdisease and is commonly seen in the emergencydepartment. The aim of this study was to determine theassociations of thrombus localization with white blood cell(WBC) subtypes and the neutrophil-to-lymphocyte ratio(NLR).Material-Method: We retrospectively analyzed the dataof acute PE patients who were admitted to the hospital in theperiod between the dates from 1 January 2017 to 30 June 2018.The coexisting diseases, risk factors, clinical, laboratory, andradiological findings were retrospectively evaluated.Results: The mean age of the patients was 63.40±17.11years and 119 (53.1%) patients were female. The mostfrequent complaint was dyspnea (62.5%), the most frequentcoexisting disease was the chronic obstructive pulmonarydisease (30.4%), and the most frequent risk factor wasimmobilization (21.4%). Thrombus was mostly present in thepulmonary arteries (PAs) bilaterally (n=103). The thrombuswas localized in the lobar PAs in 46.4% of the patients. Inthe patients having a thrombus in the main PA; the meanWBC and neutrophil counts, platelet distribution width, andNLR values were higher than those in the patients having athrombus in the distal branches of PA. The parameter with thehighest sensitivity and specificity was found to be NLR.Conclusions: A high NLR value is independently associatedwith a proximal localization of the thrombus in patients with PE.

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