Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene

güzel, hakan; Yildirim, Ali Cihat; anuk, turgut; GÜNAL, Elnare; Çığşar, Gülşen

Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene

Turgut ANUK, (Kafkas University Faculty of Medicine, Department of General Surgery, Kars, Turkey)

Ali Cihat YILDIRIM, (Kars Harakani State Hospital, Clinic of General Surgery, Kars, Turkey)

Hakan GÜZEL, (Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of General Surgery, Ankara, Turkey)

Gülşen ÇIĞŞAR, (Kafkas University Faculty of Medicine, Department of Emergency Medicine, Kars, Turkey)

Elnare GÜNAL (Kafkas University Faculty of Medicine, Department of Emergency Medicine, Kars, Turkey)

Türk Kolon ve Rektum Hastalıkları Dergisi

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Yıl: 2017 Cilt: 27 Sayı: 2 Sayfa Aralığı: 38 - 43 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene

Öz:

Amaç: Fournier gangreni (FG) anorektal bölgenin klinik olarak çok hızlı kötüleşen, ölümcül nekrotizan fasiitidir. FG tedavisinin temelini agresif cerrahi debridman oluşturur. Güncel skorlama sistemleri FG'de mortalite üzerine yoğunlaşmıştır. Bununla birlikte serum belirteçleri yararlı olabilir. Bu çalışmada FG hastalarındaki debridman sayısını belirlemede monosit-lenfosit oranının (MLO) klinik etkisini ortaya koymayı amaçladık.Yöntem: 2010-2016 yılları arasında hastanelerimiz acil servisinde FG tanısıyla tanı konup opere edilen 59 hasta çalışmaya dahil edildi. Tek debridman uygulanan grup 1 ve birden çok debridman uygulanan hastalar grup 2 olarak iki gruba ayrıldılar. Grupların ortalama yaş, cinsiyet, semptom süresi, predispozan faktör, yara kültür pozitifliği, kolostomi durumu, yatış anındaki MLO'lar, tedavi protokolleri, mortalite oranları karşılaştırıldı.Bulgular: İki grup arasında yara kültür sonuçları ve kolostomi durumları arasında istatistiksel anlamlı fark bulundu (p=0,001 ve p=0,008). Mortalite oranları arasında anlamlı fark bulunamadı (p=0,749). Predispozan faktörler ve semptomların süresi arasında gruplar arası anlamlı fark bulunamadı (p=0,069, p=0,091). Grup 2'de MLO anlamlı oranda yüksekti (p<0,001). 0,549 cut-off değerinde MLO debridman sayını öngörmede %79,4 sensitivite ve %76 oranında spesifiteye sahipti. Ayrıca MLO debridman sayısını diğer faktörlerden bağımsız olarak öngörebilmekteydi (p<0,001).Sonuç: MLO değeri birden çok debridman yapılan hastalarda anlamlı oranda yüksek bulundu. Bu sonuç, MLO'nun tek bir parametre olarak FG ciddiyetini göstermesi bakımından önemlidir. Gelecekte düzenlenebilecek daha yüksek hasta popülasyonlu çalışmalar parametrenin gücünü gösterebilmeleri açısından önem kazanmıştır.

Anahtar Kelime:

Konular: Gastroenteroloji ve Hepatoloji

Monosit-Lenfosit Oranının Fournier Gangreni Tedavisinde Debridman Sayısına Karar Vermede Klinik Etkisi

Öz:

Aim: Fournier's gangrene (FG) is a rapidly progressive, fulminant necrotizing fasciitis of the anogenital region. Treatment of FG consists of aggressive surgical debridements. The current scoring systems in FG focus on mortality. However, simple biomarkers could be useful. Here we aim to investigate the clinical usefulness of monocyte-to-lymphocyte ratio (MLR) in determining the number of debridements in FG patients.Method: Fifty-nine patients were diagnosed with FG and operated in the emergency unit between 2010 and 2016. The patients were separated into a single-debridement group and a multiple-debridement group. The groups were compared in terms of mean age, gender, duration of symptoms, predisposing factors, wound culture positivity, MLR values at admission, treatment protocols, and mortality rates. Results: The two groups differed significantly in wound culture results and colostomy status (p=0.001 and p=0.008). There was no significant difference in mortality rate (p=0.749). Furthermore, there were no significant differences between the groups in terms of predisposing factors or duration of symptoms (p=0.069 and p=0.091). The multiple-debridement group had a significantly higher MLR value (p<0.001). MLR under the cutoff value of 0.549 had 79.4% sensitivity and 76% specificity in the prediction of number of debridements. Furthermore, MLR value could predict the number of debridements independently from other factors (p<0.001).Conclusion: MLR value was significantly higher in patients who underwent multiple debridements. Thus, MLR shows promise as a single-parameter biomarker for FG severity. Future studies should focus on this parameter using a larger number of FG patients.

Anahtar Kelime:

Konular: Gastroenteroloji ve Hepatoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	anuk t, Yildirim A, güzel h, Çığşar G, GÜNAL E (2017). Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. , 38 - 43.
Chicago	anuk turgut,Yildirim Ali Cihat,güzel hakan,Çığşar Gülşen,GÜNAL Elnare Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. (2017): 38 - 43.
MLA	anuk turgut,Yildirim Ali Cihat,güzel hakan,Çığşar Gülşen,GÜNAL Elnare Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. , 2017, ss.38 - 43.
AMA	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. . 2017; 38 - 43.
Vancouver	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. . 2017; 38 - 43.
IEEE	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E "Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene." , ss.38 - 43, 2017.
ISNAD	anuk, turgut vd. "Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene". (2017), 38-43.

APA	anuk t, Yildirim A, güzel h, Çığşar G, GÜNAL E (2017). Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. Türk Kolon ve Rektum Hastalıkları Dergisi, 27(2), 38 - 43.
Chicago	anuk turgut,Yildirim Ali Cihat,güzel hakan,Çığşar Gülşen,GÜNAL Elnare Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. Türk Kolon ve Rektum Hastalıkları Dergisi 27, no.2 (2017): 38 - 43.
MLA	anuk turgut,Yildirim Ali Cihat,güzel hakan,Çığşar Gülşen,GÜNAL Elnare Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. Türk Kolon ve Rektum Hastalıkları Dergisi, vol.27, no.2, 2017, ss.38 - 43.
AMA	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. Türk Kolon ve Rektum Hastalıkları Dergisi. 2017; 27(2): 38 - 43.
Vancouver	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene. Türk Kolon ve Rektum Hastalıkları Dergisi. 2017; 27(2): 38 - 43.
IEEE	anuk t,Yildirim A,güzel h,Çığşar G,GÜNAL E "Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene." Türk Kolon ve Rektum Hastalıkları Dergisi, 27, ss.38 - 43, 2017.
ISNAD	anuk, turgut vd. "Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier's Gangrene". Türk Kolon ve Rektum Hastalıkları Dergisi 27/2 (2017), 38-43.