Yusuf Tanrıkulu1, Ceren Şen Tanrıkulu2, Mehmet Zafer Sabuncuoğlu3, Ayetullah Temiz4, Furuzan Köktürk5, Boran Yalçın6. 1. Department of General Surgery, Zonguldak Atatürk State Hospital, Zonguldak-Turkey. drtanrikulu@hotmail.com. 2. Department of Emergency Medicine, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey. 3. Department of General Surgery, Süleyman Demirel University Faculty of Medicine, Isparta-Turkey. 4. Department of General Surgery, Erzurum Area Training and Research Hospital, Erzurum-Turkey. 5. Department of Biostatistics, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey. 6. Department of General Surgery, Zonguldak Atatürk State Hospital, Zonguldak-Turkey.
Abstract
BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophil-lymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, as were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain. RESULTS: Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group (p<0.001), though no difference in NLR was found between the AMI and NVBN groups. In addition, WBC count, CRP level, and NLR were higher in the NVBN group than in the controls (p<0.001). CONCLUSION: We suggest that preoperative NLR aids in the diagnosis of AMI, and can be used to distinguish this condition from NVBN. NLR should be calculated, in addition to clinical examination.
BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophil-lymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, as were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain. RESULTS: Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group (p<0.001), though no difference in NLR was found between the AMI and NVBN groups. In addition, WBC count, CRP level, and NLR were higher in the NVBN group than in the controls (p<0.001). CONCLUSION: We suggest that preoperative NLR aids in the diagnosis of AMI, and can be used to distinguish this condition from NVBN. NLR should be calculated, in addition to clinical examination.
Authors: Andrew S Miller; Kathryn Boyce; Benjamin Box; Matthew D Clarke; Sarah E Duff; Niamh M Foley; Richard J Guy; Lisa H Massey; George Ramsay; Dominic A J Slade; James A Stephenson; Phil J Tozer; Danette Wright Journal: Colorectal Dis Date: 2021-02 Impact factor: 3.917
Authors: Kemal Eyvaz; Onur Ilkay Dincer; Murat Kazim Kazan; Aydın Dincer; Arif Aslaner; Aylin Acar; Tugrul Cakir Journal: North Clin Istanb Date: 2021-12-31