Novel hematologic inflammatory parameters to predict acute mesenteric ischemia

Abstract

Acute mesenteric ischaemia (AMI) is an emergency condition that requires urgent diagnosis. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been studied as inflammatory biomarkers in atherosclerosis, but data regarding AMI are lacking. The study population included patients with AMI (n = 46) versus age and sex-matched healthy controls (n = 46). Computed multidetector tomographic angiography was performed to diagnose AMI. NLR and PLR were calculated using complete blood count. C-reactive protein (CRP) levels were also analyzed. Neutrophil levels and lymphocytes were significantly higher in patients with AMI than in the control individuals (P < 0.001 and P = 0.43, respectively). NLR levels were significantly higher in patients with AMI compared with that in the control individuals (P < 0.001). Platelet levels did not reach statistical significance between the groups (P = 0.709). However, patients with AMI had significantly higher PLR levels than the control group (P = 0.039). CRP levels on admission were higher in patients with AMI in comparison with control individuals. There was also a positive correlation between NLR and CRP (r = 0.548, P < 0.001), and between PLR and CRP (r = 0.528, P < 0.001). NLR level greater than 4.5, measured on admission, yielded an area under the curve value of 0.790 (95% confidence interval 0.681-0.799, sensitivity 77%, specificity 72%), and PLR level of greater than 157 yielded an area under the curve value of 0.604 (95% confidence interval 0.486-0.722, sensitivity 59%, specificity 65%). Patients with AMI had increased NLR, PLR, and CRP levels compared with controls. Increased NLR and PLR was an independent predictor of AMI.

Prognostic Factors and Evaluation through Mannheim Peritonitis Index and Platelet-to-Lymphocyte Ratio in Acute Mesenteric Ischemia

“…[20] Studies of P/L ratio, however, are limited in the literature. A study conducted by Toptas et al [10] reported that elevated P/L ratio, along with elevated levels of other hematological markers, would be an important marker in the diagnosis of AMI, as well as prediction of prognosis and mortality. Our study results included a statistically significant difference in survival according to P/L ratio.…”

“…P/L ratio has been studied in many inflammatory events, ranging from coronary artery disease to malignancies, and its value in prediction of prognosis has been well demonstrated. [9,10] A study conducted by Kahramanca et al [17] reported that P/L ratio was a good marker to estimate prognosis and debridement of Fournier's gangrene. It has also been shown to be an important marker for malignancy, and a study conducted by Stotz et al [18] reported that elevated P/L value was a negative factor regarding curative resection in gastrointestinal stromal tumor.…”

“…However, these studies have reported that high P/L value was associated with increased mortality. [10] ORIGINAL ARTICLE Ulus Travma Acil Cerrahi Derg, July 2017, Vol. 23, No.…”

“…[8] The platelet-to-lymphocyte (P/L) ratio has been recognized in recent studies as a marker that, interestingly, can predict mortality in many inflammatory events, ranging from coronary artery disease to malignancy. [9,10] While many studies have been conducted using the parameter of mean platelet volume (MPV) in AMI, the number of studies demonstrating the importance of P/L as a marker in prognosis is very limited. However, these studies have reported that high P/L value was associated with increased mortality.…”

Cholesterol Crystal Embolism as the Reason of Acute Non-Occlusive Mesenteric Ischemia After Infrarenal Aortic Aneurism Repair

“…Холестероловые кристаллы, эмболизируя артериолы, повреждают эндотелий, индуцируя активацию свёртывающей системы крови с агрегацией тромбоцитов, что приводит к микротромбообразованию, ишемии и некрозу ткани, тромбоцитопении потребления. По мнению ряда авторов, развитие тромбоцитопении и системной воспалительной реакции после операции на брюшной аорте является маркером абдоминальной катастрофы, в том числе и при ОННМК [8,14,15].…”