Research Article
Are using neutrophil‐to‐lymphocyte ratio and platelet parameters useful in predicting Short Bowel Syndrome in patients with mesenteric ischemia?
Abstract
Objective: Acute mesenteric ischemia (AMI) is a potentially life-threatening medical condition that results in bowel infarction and gangrene. It usually occurs over the age of 60 and is seen in both sexes at similar rates. Early diagnosis and treatment are the cornerstones in the treatment of AMI. Although different biochemical markers for AMI are used clinically, no specific laboratory test has been proven to identify the presence of ischemic or necrotic bowel. In this study, we aimed to evaluate Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLT/LYM), NLR/PLT, mean platelet volume-PLT ratio (MPV)/PLT, and MPV*NLR/PLT could be a useful tool for early prediction of the severity of AMI.
Method: We analyzed retrospectively records of 105 patients diagnosed with acute AMI who were operated on at our clinic. We investigated patient demographics, clinical symptoms, concomitant diseases, blood test results, and data regarding the surgical procedure performed and the resection's width. The patients were divided into two groups as short bowel syndrome (SBS) developing and non-developing.
Results: We enrolled a total of 105 AMI patients in this study. There was no significant difference between the rates of non-SBS and SBS in terms of age, gender, diabetes mellitus, and smoking status. WBC, NEU, LYM, and MPV were higher, and PLT was lower in the SBS group. There were no statistically significant differences in MPV/PLT between the two groups. The combined values of NLR, PLT, and MPV were also compared between non-SBS and SBS groups. According to our results, the means of NLR, PLT/LYM, NLR/PLT, MPV/NLR, and MPV*NLR/PLT variables were statistically significantly different between the two groups.
Conclusions: Our findings showed that NLR, NLR/PLT, MPV/PLT, MPV*NLR, and MPV*NLR/PLT could be a relatively better tool for early prediction of the severity of AMI and SBS. Further studies have to be carried out to investigate the best parameter for predicting the severity or prognosis of AMI.
References
- 1) Emile SH, Khan SM, Barsoum SH. Correction to: Predictors of bowel necrosis in patients with acute mesenteric ischemia: systematic review and meta-analysis. Updates Surg. 2020 Dec;72(4):1297-1298. doi: 10.1007/s13304-020-00863-x.
- 2) Miller ED, Fisher JL, Haglund KE, Grecula JC, Xu-Welliver M, Bertino EM, He K, Shields PG, Carbone DP, Williams TM, Otterson GA, Bazan JG. Identifying patterns of care for elderly patients with non-surgically treated stage III non-small cell lung cancer: an analysis of the national cancer database. Radiat Oncol. 2018 Oct 5;13(1):196. doi: 10.1186/s13014-018-1142-7.
- 3) Luther B, Mamopoulos A, Lehmann C, Klar E. The Ongoing Challenge of Acute Mesenteric Ischemia. Visc Med. 2018 Jul;34(3):217-223. doi: 10.1159/000490318.
- 4) Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, Schleck C, Ilstrup D, Harmsen WS, Noel AA. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002 Mar;35(3):445-52. doi: 10.1067/mva.2002.120373.
- 5) Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017 Aug 7;12:38. doi: 10.1186/s13017-017-0150-5.
- 6) Copin P, Zins M, Nuzzo A, Purcell Y, Beranger-Gibert S, Maggiori L, Corcos O, Vilgrain V, Ronot M. Acute mesenteric ischemia: A critical role for the radiologist. Diagn Interv Imaging. 2018 Mar;99(3):123-134. doi: 10.1016/j.diii.2018.01.004.
- 7) Kärkkäinen JM, Acosta S. Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches. Best Pract Res Clin Gastroenterol. 2017 Feb;31(1):27-38. doi: 10.1016/j.bpg.2016.11.003.
- 8) Le Beyec J, Billiauws L, Bado A, Joly F, Le Gall M. Short Bowel Syndrome: A Paradigm for Intestinal Adaptation to Nutrition? Annu Rev Nutr. 2020 Sep 23;40:299-321. doi: 10.1146/annurev-nutr-011720-122203.
- 9) O'Keefe SJ, Buchman AL, Fishbein TM, Jeejeebhoy KN, Jeppesen PB, Shaffer J. Short bowel syndrome and intestinal failure: consensus definitions and overview. Clin Gastroenterol Hepatol. 2006 Jan;4(1):6-10. doi: 10.1016/j.cgh.2005.10.002.
- 10) Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, Cha JK, Han JY. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio. J Clin Lab Anal. 2019 Mar;33(3):e22714. doi: 10.1002/jcla.22714.
- 11) Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, Cha JK, Han JY. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio. J Clin Lab Anal. 2019 Mar;33(3):e22714. doi: 10.1002/jcla.22714.
- 12) Akıl E, Akıl MA, Varol S, Özdemir HH, Yücel Y, Arslan D, Akyüz A, Alan S. Echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio are novel inflammatory predictors of cerebral ischemic stroke. J Stroke Cerebrovasc Dis. 2014 Oct;23(9):2328-34. doi: 10.1016/j.jstrokecerebrovasdis.2014.04.028
- 13) Celikbilek A, Ismailogullari S, Zararsiz G. Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease. J Clin Lab Anal. 2014 Jan;28(1):27-31. doi: 10.1002/jcla.21639.
- 14) Merle C, Lepouse C, De Garine A, Frayssinet N, Leymarie F, Leon A, Jolly D. Surgery for mesenteric infarction: prognostic factors associated with early death within 72 hours. J Cardiothorac Vasc Anesth. 2004 Dec;18(6):734-41. doi: 10.1053/j.jvca.2004.08.011.
- 15) Huang HH, Chang YC, Yen DH, Kao WF, Chen JD, Wang LM, Huang CI, Lee CH. Clinical factors and outcomes in patients with acute mesenteric ischemia in the emergency department. J Chin Med Assoc. 2005 Jul;68(7):299-306. doi: 10.1016/S1726-4901(09)70165-0.
- 16) Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I, Lalic D, Milovanovic T, Dumic I, Krivokapic Z. Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer. Dis Markers. 2019 Jan 17;2019:6036979. doi: 10.1155/2019/6036979.
- 17) Daly ME. Determinants of platelet count in humans. Haematologica. 2011 Jan;96(1):10-3. doi: 10.3324/haematol.2010.035287.
- 18) Türkoğlu A, Gül M, Oğuz A, Bozdağ Z, Ülger BV, Yılmaz A, Aldemir M. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg. 2015 May;100(5):962-5. doi: 10.9738/INTSURG-D-14-00268.1.
Year 2021,
Volume: 43 Issue: 4, 413 - 419, 31.12.2021
Abstract
References
- 1) Emile SH, Khan SM, Barsoum SH. Correction to: Predictors of bowel necrosis in patients with acute mesenteric ischemia: systematic review and meta-analysis. Updates Surg. 2020 Dec;72(4):1297-1298. doi: 10.1007/s13304-020-00863-x.
- 2) Miller ED, Fisher JL, Haglund KE, Grecula JC, Xu-Welliver M, Bertino EM, He K, Shields PG, Carbone DP, Williams TM, Otterson GA, Bazan JG. Identifying patterns of care for elderly patients with non-surgically treated stage III non-small cell lung cancer: an analysis of the national cancer database. Radiat Oncol. 2018 Oct 5;13(1):196. doi: 10.1186/s13014-018-1142-7.
- 3) Luther B, Mamopoulos A, Lehmann C, Klar E. The Ongoing Challenge of Acute Mesenteric Ischemia. Visc Med. 2018 Jul;34(3):217-223. doi: 10.1159/000490318.
- 4) Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, Schleck C, Ilstrup D, Harmsen WS, Noel AA. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002 Mar;35(3):445-52. doi: 10.1067/mva.2002.120373.
- 5) Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017 Aug 7;12:38. doi: 10.1186/s13017-017-0150-5.
- 6) Copin P, Zins M, Nuzzo A, Purcell Y, Beranger-Gibert S, Maggiori L, Corcos O, Vilgrain V, Ronot M. Acute mesenteric ischemia: A critical role for the radiologist. Diagn Interv Imaging. 2018 Mar;99(3):123-134. doi: 10.1016/j.diii.2018.01.004.
- 7) Kärkkäinen JM, Acosta S. Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches. Best Pract Res Clin Gastroenterol. 2017 Feb;31(1):27-38. doi: 10.1016/j.bpg.2016.11.003.
- 8) Le Beyec J, Billiauws L, Bado A, Joly F, Le Gall M. Short Bowel Syndrome: A Paradigm for Intestinal Adaptation to Nutrition? Annu Rev Nutr. 2020 Sep 23;40:299-321. doi: 10.1146/annurev-nutr-011720-122203.
- 9) O'Keefe SJ, Buchman AL, Fishbein TM, Jeejeebhoy KN, Jeppesen PB, Shaffer J. Short bowel syndrome and intestinal failure: consensus definitions and overview. Clin Gastroenterol Hepatol. 2006 Jan;4(1):6-10. doi: 10.1016/j.cgh.2005.10.002.
- 10) Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, Cha JK, Han JY. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio. J Clin Lab Anal. 2019 Mar;33(3):e22714. doi: 10.1002/jcla.22714.
- 11) Lim HH, Jeong IH, An GD, Woo KS, Kim KH, Kim JM, Cha JK, Han JY. Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio. J Clin Lab Anal. 2019 Mar;33(3):e22714. doi: 10.1002/jcla.22714.
- 12) Akıl E, Akıl MA, Varol S, Özdemir HH, Yücel Y, Arslan D, Akyüz A, Alan S. Echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio are novel inflammatory predictors of cerebral ischemic stroke. J Stroke Cerebrovasc Dis. 2014 Oct;23(9):2328-34. doi: 10.1016/j.jstrokecerebrovasdis.2014.04.028
- 13) Celikbilek A, Ismailogullari S, Zararsiz G. Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease. J Clin Lab Anal. 2014 Jan;28(1):27-31. doi: 10.1002/jcla.21639.
- 14) Merle C, Lepouse C, De Garine A, Frayssinet N, Leymarie F, Leon A, Jolly D. Surgery for mesenteric infarction: prognostic factors associated with early death within 72 hours. J Cardiothorac Vasc Anesth. 2004 Dec;18(6):734-41. doi: 10.1053/j.jvca.2004.08.011.
- 15) Huang HH, Chang YC, Yen DH, Kao WF, Chen JD, Wang LM, Huang CI, Lee CH. Clinical factors and outcomes in patients with acute mesenteric ischemia in the emergency department. J Chin Med Assoc. 2005 Jul;68(7):299-306. doi: 10.1016/S1726-4901(09)70165-0.
- 16) Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I, Lalic D, Milovanovic T, Dumic I, Krivokapic Z. Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer. Dis Markers. 2019 Jan 17;2019:6036979. doi: 10.1155/2019/6036979.
- 17) Daly ME. Determinants of platelet count in humans. Haematologica. 2011 Jan;96(1):10-3. doi: 10.3324/haematol.2010.035287.
- 18) Türkoğlu A, Gül M, Oğuz A, Bozdağ Z, Ülger BV, Yılmaz A, Aldemir M. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg. 2015 May;100(5):962-5. doi: 10.9738/INTSURG-D-14-00268.1.
There are 18 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | December 31, 2021 |
| Acceptance Date | November 30, 2021 |
| Published in Issue | Year 2021Volume: 43 Issue: 4 |