Acil Servise Koah Alevlenme İle Başvuran Hastalarda Nötrofil/Lenfosit Oranının Prognostik Önemi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: KOAH giderek artan ekonomik ve sosyal yüküyle dünya çapında morbidite ve mortalitenin önde gelen nedenlerinden biri haline gelmiştir. Hastalığın prognozunu kötü etkileyen KOAH alevlenmeleri; tekrarlayan acil servis başvuruları ve hastane yatışları nedeniyle ekonomik yükte önemli bir pay sahibi olmuştur. Çalışmanın amacı, acil servise KOAH alevlenme ile başvuran hastalarda hızlı ulaşılabilen laboratuvar tetkiklerinden elde edilen NLR’nin prognostik önemini araştırmak, hastane içi mortalite, hastaneye yatış veya taburculuk kararlarını öngörebilirliğini değerlendirmektir.
Gereç ve yöntem: Bu çalışma retrospektif, tek merkezli bir çalışma olarak 30.10.2021-30.10.2023 tarihleri arasında Necmettin Erbakan Ünivesitesi Tıp Fakültesi Hastanesi Acil Tıp kliniğine KOAH alevlenme ile başvuran, 18 yaş ve üzerinde, başvurusunda hemogram ve kan gazı tetkikleri çalışılmış olan hastalar üzerinden yapılmıştır. Hastaların acil servis sonlanımları (taburcu, servis yatışı, yoğun bakım ünitesine yatış, exitus) ve hastane sonlanımları (taburcu, exitus) kaydedilmiştir. Elde edilen veriler SPSS (Statistical Package for Social Sciences for Windows) 22 programı kullanılarak analiz edildi. NLR değerinin mortaliteyi tahmin etmede test olarak kullanılıp kullanılamayacağını belirlemek için ROC analizi uygulandı. Tüm testler için p<0,05 değeri istatistiksel olarak anlamlı kabul edildi.
Bulgular: Çalışmaya acil servise KOAH alevlenme ile başvuran 213 hasta dahil edildi. Yapılan ROC analizinde NLR düzeyinin, hastane içi mortaliteyi öngörmede istatistiki olarak kullanılabilecek (p=0,017), AUC değeri 0,656 olan bir test olduğu bulundu. Hastaların hastane içi mortalite durumunu öngörmek amacıyla pH, laktat ve NLR değerleri kullanılarak yapılan lojistik regresyon analizinde, kurulan modelin hastane içi mortaliteyi %28 oranında açıklayabildiği görüldü.
Sonuç: KOAH alevlenme ile acil servise başvuran hastalarda WBC, nötrofil, eozinofil, pH, PCO2, ELR ve NLR, hastaların hastane yatışı veya taburculuk kararını vermede kullanılabilecek çok güçlü değerler olmasa da hekimlerin faydalanabileceği parametrelerdir. Hastane içi mortalite durumunu tahmin etmede nötrofil, laktat, NLR, eozinofil, pH ve ELR değerleri, kullanılabilecek parametrelerdir.
Introduction: COPD has become one of the leading causes of morbidity and mortality worldwide, with its increasing economic and social burden. COPD exacerbations that negatively affect the prognosis of the disease; It has had a significant share in the economic burden due to recurrent emergency room visits and hospitalizations. The aim of the study is to investigate the prognostic importance of NLR obtained from rapidly accessible laboratory tests in patients presenting to the emergency department with COPD exacerbation and to evaluate its predictability in in-hospital mortality, hospitalization or discharge decisions. Material and methods: This study was conducted as a retrospective, single-center study between 30.10.2021-30.10.2023 on patients who applied to Necmettin Erbakan University Faculty of Medicine Hospital Emergency Medicine Clinic with COPD exacerbation, who were 18 years of age and over, and whose hemogram and blood gas tests were studied at their application. Emergency department outcomes (discharge, ward admission, intensive care unit admission, exitus) and hospital outcomes (discharge, exitus) of the patients were recorded. The data obtained was analyzed using the SPSS (Statistical Package for Social Sciences for Windows) 22 program. ROC analysis was applied to determine whether the NLR value could be used as a test to predict mortality. For all tests, p value <0.05 was considered statistically significant. Results: 213 patients who presented to the emergency department with COPD exacerbation were included in the study. In the ROC analysis, it was found that the NLR level was a test that could be used statistically to predict in-hospital mortality (p=0.017), with an AUC value of 0.656. In the logistic regression analysis performed using pH, lactate and NLR values to predict the in-hospital mortality status of the patients, it was seen that the established model could explain the in-hospital mortality by 28%. Conclusion: COPD can be reserved for the emergency department with exacerbation. WBC, neutrophil, eosinophil, pH, PCO2, ELR and NLR are effects that physicians can benefit from, although they are not very strong values in cases where patients are not impaired during hospitalization or discharge. Neutrophil, lactate, NLR, eosinophil, pH and ELR values are the effect of plants in predicting in-hospital mortality.
Introduction: COPD has become one of the leading causes of morbidity and mortality worldwide, with its increasing economic and social burden. COPD exacerbations that negatively affect the prognosis of the disease; It has had a significant share in the economic burden due to recurrent emergency room visits and hospitalizations. The aim of the study is to investigate the prognostic importance of NLR obtained from rapidly accessible laboratory tests in patients presenting to the emergency department with COPD exacerbation and to evaluate its predictability in in-hospital mortality, hospitalization or discharge decisions. Material and methods: This study was conducted as a retrospective, single-center study between 30.10.2021-30.10.2023 on patients who applied to Necmettin Erbakan University Faculty of Medicine Hospital Emergency Medicine Clinic with COPD exacerbation, who were 18 years of age and over, and whose hemogram and blood gas tests were studied at their application. Emergency department outcomes (discharge, ward admission, intensive care unit admission, exitus) and hospital outcomes (discharge, exitus) of the patients were recorded. The data obtained was analyzed using the SPSS (Statistical Package for Social Sciences for Windows) 22 program. ROC analysis was applied to determine whether the NLR value could be used as a test to predict mortality. For all tests, p value <0.05 was considered statistically significant. Results: 213 patients who presented to the emergency department with COPD exacerbation were included in the study. In the ROC analysis, it was found that the NLR level was a test that could be used statistically to predict in-hospital mortality (p=0.017), with an AUC value of 0.656. In the logistic regression analysis performed using pH, lactate and NLR values to predict the in-hospital mortality status of the patients, it was seen that the established model could explain the in-hospital mortality by 28%. Conclusion: COPD can be reserved for the emergency department with exacerbation. WBC, neutrophil, eosinophil, pH, PCO2, ELR and NLR are effects that physicians can benefit from, although they are not very strong values in cases where patients are not impaired during hospitalization or discharge. Neutrophil, lactate, NLR, eosinophil, pH and ELR values are the effect of plants in predicting in-hospital mortality.
Açıklama
Anahtar Kelimeler
KOAH alevlenme, COPD exacerbation, Nötrofil lenfosit oranı, Neutrophil lymphocyte ratio, Laktat, Lactate
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Doğru, M. (2024). Acil Servise Koah Alevlenme İle Başvuran Hastalarda Nötrofil/Lenfosit Oranının Prognostik Önemi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İlk ve Acil Yardım Anabilim Dalı, Konya.
