Is the Platelet to Lymphocyte Ratio a Potential Biomarker for Predicting Mortality in Peptic Ulcer Perforation?

Abstract

Background: Despite surgical treatment of peptic ulcer perforation (PUP), the high rates of morbidity and mortality have motivated researchers to search for new laboratory markers to predict morbidity and mortality. The aim of this study was to investigate the relation between pre-operative laboratory values and demographic factors and post-operative mortality in patients undergoing surgery for PUP. Patients and Methods: A retrospective study was made of the clinical findings and laboratory data of patients operated on for a diagnosis of PUP in the general surgery clinic between 2014 and 2018. The patients were separated into two groups according to survival (PUP-S) or mortality (PUP-M) and the differences between the groups were evaluated. Result: In the analysis of the patient data, age (p = 0.014), female gender (p = 0.005), length of stay in hospital (p = 0.009), platelet to lymphocyte ratio (PLR) (p = 0.09), and neutrophil to lymphocyte ratio (NLR) (p = 0.010) values were determined to be high and lymphocyte count was low (p = 0.046) in the PUP-M group. A positive correlation was determined between mortality and age, length of stay in hospital, PLR, and NLR (p < 0.05). A substantial negative correlation was determined between mortality and gender and lymphocyte count (p < 0.05). As a result of the receiver operating characteristic (ROC) curve analysis, it was determined that a PLR value <322.22 (p = 0.009) and lymphocyte count <0.67 • 10 3 microliter (p = 0.035) could have diagnostic value in the prediction of the possibility of mortality in patients operated on because of PUP. Conclusion: This study results suggested that PLR, NLR, and lymphocyte count values could be used as new biomarkers to identify the mortality risk in patients operated on for peptic ulcer perforation.

Platelet to Lymphocyte Ratio Associated with Prolonged Hospital Length of Stay Postpeptic Ulcer Perforation Repair: An Observational Descriptive Analysis

“…The lymphocyte count is the key in determining the P/LR. The older age, high platelet count, high N/LR, P/LR ratios, and low lymphocyte count were associated with mortality in our study, which is [23]. The discriminatory power of P/LR in the present study is reflected by the AUC 0.702 and NPV of 93%.…”

“…The low mortality rate is partly due to the young age of our patients besides the health care system with easy access, free emergency care, and availability of immediate advanced surgical and critical care. Aydin and Pehlivanlı, though studied small sample size, reported a 17% death rate and a mean age of 54.5 years [23]. In patients who underwent coronary artery bypass surgery (CABG), the preoperative P/LR was found to be an independent risk factor for the development of arrhythmia and neurologic events, reoperation for sternum dehiscence, prolonged hospital length of stay, and mortality in the early postoperative period [30].…”

“…Also, P/LR was found to be high in nonsurvival traumatized patients without sepsis [13,15,16]. The P/LR was reported as a predictor of high mortality in patients who had surgery for PPU in a study by Aydin and Pehlivanlı [23]. The latter is the only study utilizing P/LR in PPU; however, the sample size was small (only 23 patients), and not validated yet.…”

Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study

“…APACHE II [ 17 ], SAPS II [ 17 ], MPM [ 17 ], Jabalpur [ 30 ], MPI [ 15 ]) as these studies did not include any of the three systems (ASA, Boey or PULP) under examination and hence were out of the scope of the current study. Likewise, we did not examine other potential biomarkers (platelet to lymphocyte ratio, neutrophil to lymphocyte ratio) for predicting mortality in peptic ulcer perforation [ 31 ].…”

Platelet to Lymphocyte Ratio as a Predictive Biomarker for Preoperative Diagnosis of Parathyroid Adenoma

“…Since the study was conducted retrospectively, written informed consent was not required. (2,7,8,10,11,12). As a result of this process, the neutrophil and platelet counts increase, while the lymphocyte count decreases.…”