Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index

terzi, özlem; BAYDIN, Ahmet; GÜZEL, Murat; ÖZGEN, Emre; DEMİR, Mehmet Tevfik; Yücel, Murat

doi:10.5455/annalsmedres.2019.01.025

Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index

Murat GÜZEL, (Samsun Training and Research Hospital)

Emre ÖZGEN, (Samsun Training and Research Hospital)

Özlem TERZİ, (Ondokuz Mayıs University)

Mehmet Tevfik DEMİR, (Samsun Training and Research Hospital)

Murat YÜCEL, (Samsun Training and Research Hospital)

Ahmet BAYDIN (Ondokuz Mayıs University)

Annals of Medical Research

13 1

Yıl: 2019 Cilt: 26 Sayı: 4 Sayfa Aralığı: 653 - 657 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2019.01.025 İndeks Tarihi: 26-12-2019

Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index

Öz:

Aim: We aimed to determine whether Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), D-dimer, and troponin values were correlated with the simplified Pulmonary Embolism Severity Index (sPESI) in patients diagnosed as having Pulmonary Embolism (PE) in the emergency room.Material and Methods: Forty-three patients diagnosed as having PE in the emergency department were divided into low and high-risk groups according to the sPESI. We investigated whether NLR, MLR, and PLR, d-dimer, troponin-I, and Pulmonary Artery Pressure (PAP) had any effect in determining the severity of PE. Also, patients were divided into groups as those with PAP ≤20 or >20 mm Hg, Systolic Blood Pressure (SBP) ≤100 or >100 mm Hg, and those receiving or not receiving thrombolytic treatment, and compared.Results: There was a statistically significant difference between patients with low sPESI (n=10) and those with high sPESI (n=33) in terms of age (p=0.001), pulse (p=0.016), oxygen saturation (p=0.039), troponin-I (p=0.029) and PAP (p=0.032), but there was no difference between the groups in terms of NLR (p=0.796), MLR (p=0.656), PLR (p=0.863), and d-dimer (p=0.343). There was a statistically significant difference between patients who did (n=6) and did not (n=37) receive thrombolytic treatment in terms of troponin-I (p=0.012), but there was no difference between the groups in terms of NLR (p=0.861), MLR (p=0.335), and PLR (p=0.277).Conclusion: NLR, MLR, PLR and d-dimer levels were found not to be effective in determining the severity of PE. Troponin-I was associated with sPESI and was considered as an effective marker in determining the thrombolytic treatment.

Anahtar Kelime:

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

1. Cohen AT, Agnelli G, Anderson FA, et al. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007;98:756-64.
2. Squizzato A, Donadini MP, Galli L, et al. Prognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 2012;10:1276-90.
3. Aujesky D, Obrosky DS, Stone RA, Auble TE, Perrier A, Cornuz J, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005;172:1041-46.
4. Dentali F, Conte G, Guasti L. Neutrophil-to-lymphocyte ratio: a new prognostic factor even in patients with heart failure. Pol Arch Med Wewn 2016;126:116-7.
5. Ergelen M, Uyarel H, Altay S, ,et al. Predictive value of elevated neutrophil to lymphocyte ratio in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost 2014;20:427-32.
6. Bhat TM, Afari ME, Garcia LA. Neutrophil lymphocyte ratio in peripheral vascular disease: a review. Expert Rev Cardiovasc Ther 2016;14:871-75.
7. Wang Q, Ma J, Jiang Z, et al. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis. Int Angiol. 2018;37:4-11.
8. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353:1386-89.
9. Barra SN, Paiva L, Providencia R, et al. A review on state-of-the-art data regarding safe early discharge following admission for pulmonary embolism: what do we know? Clinical cardiology 2013;36:507-15.
10. Jimenez D, Lobo JL, Barrios D, et al. Risk stratification of patients with acute symptomatic pulmonary embolism. Intern Emerg Med 2016;11:11-8.
11. Jimenez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010;170:1383-89.
12. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5-14.
13. Cho KH, Jeong MH, Ahmed K, et al. Value of early risk stratification using hemoglobin level and neutrophil-to-lymphocyte ratio in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 2011;107:849-56.
14. Jo JY, Lee MY, Lee JW, et al. Leukocytes and systemic inflammatory response syndrome as prognostic factors in pulmonary embolism patients. BMC Pulm Med 2013;13:74.
15. Kayrak M, Erdogan HI, Solak Y, Akilli H, Gül EE, Yildirim O,et al. Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a restrospective study. Heart Lung Circ 2014;23:56-62.
16. Karatas MB, Ipek G, Onuk T, et al. Assessment of Prognostic Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Patients with Pulmonary Embolism. Acta Cardiol Sin 2016;32:313-20.
17. Akgullu C, Omurlu IK, Eryilmaz U, et al. Predictors of early death in patients with acute pulmonary embolism. Am J Emerg Med 2015;33:214-21.
18. Galliazzo S, Nigro O, Bertu L, et al. Prognostic role of neutrophils to lymphocytes ratio in patients with acute pulmonary embolism: a systematic review and meta-analysis of the literature. Intern Emerg Med 2018;13:603-8.
19. Ghaffari S, Sepehrvand N, Pourafkari L, et al. Factors associated with elevated cardiac troponin levels in patients with acute pulmonary thromboembolism. J Crit Care 2018;44:383-87.
20. Spirk D, Aujesky D, Husmann M, et al. Cardiac troponin testing and the simplified Pulmonary Embolism Severity Index. The SWIss Venous ThromboEmbolism Registry (SWIVTER). Thromb Haemost 2011;106:978-84.
21. Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014;35:3033-69.
22. Kozlowska M, Plywaczewska M, Koc M, Pacho S, Wyzgal A, Zdonczyk O, et al. d-Dimer Assessment Improves the Simplified Pulmonary Embolism Severity Index for In-Hospital Risk Stratification in Acute Pulmonary Embolism. Clin Appl Thromb Hemost 2018;24:1340-46.
23. Coskun F, Yilmaz D, Ursavas A, et al. Relationship between disease severity and D-dimer levels measured with two different methods in pulmonary embolism patients. Multidiscip Respir Med 2010;5:168-72.

APA	GÜZEL M, ÖZGEN E, terzi ö, DEMİR M, Yücel M, BAYDIN A (2019). Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. , 653 - 657. 10.5455/annalsmedres.2019.01.025
Chicago	GÜZEL Murat,ÖZGEN Emre,terzi özlem,DEMİR Mehmet Tevfik,Yücel Murat,BAYDIN Ahmet Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. (2019): 653 - 657. 10.5455/annalsmedres.2019.01.025
MLA	GÜZEL Murat,ÖZGEN Emre,terzi özlem,DEMİR Mehmet Tevfik,Yücel Murat,BAYDIN Ahmet Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. , 2019, ss.653 - 657. 10.5455/annalsmedres.2019.01.025
AMA	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. . 2019; 653 - 657. 10.5455/annalsmedres.2019.01.025
Vancouver	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. . 2019; 653 - 657. 10.5455/annalsmedres.2019.01.025
IEEE	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A "Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index." , ss.653 - 657, 2019. 10.5455/annalsmedres.2019.01.025
ISNAD	GÜZEL, Murat vd. "Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index". (2019), 653-657. https://doi.org/10.5455/annalsmedres.2019.01.025

APA	GÜZEL M, ÖZGEN E, terzi ö, DEMİR M, Yücel M, BAYDIN A (2019). Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. Annals of Medical Research, 26(4), 653 - 657. 10.5455/annalsmedres.2019.01.025
Chicago	GÜZEL Murat,ÖZGEN Emre,terzi özlem,DEMİR Mehmet Tevfik,Yücel Murat,BAYDIN Ahmet Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. Annals of Medical Research 26, no.4 (2019): 653 - 657. 10.5455/annalsmedres.2019.01.025
MLA	GÜZEL Murat,ÖZGEN Emre,terzi özlem,DEMİR Mehmet Tevfik,Yücel Murat,BAYDIN Ahmet Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. Annals of Medical Research, vol.26, no.4, 2019, ss.653 - 657. 10.5455/annalsmedres.2019.01.025
AMA	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. Annals of Medical Research. 2019; 26(4): 653 - 657. 10.5455/annalsmedres.2019.01.025
Vancouver	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index. Annals of Medical Research. 2019; 26(4): 653 - 657. 10.5455/annalsmedres.2019.01.025
IEEE	GÜZEL M,ÖZGEN E,terzi ö,DEMİR M,Yücel M,BAYDIN A "Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index." Annals of Medical Research, 26, ss.653 - 657, 2019. 10.5455/annalsmedres.2019.01.025
ISNAD	GÜZEL, Murat vd. "Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index". Annals of Medical Research 26/4 (2019), 653-657. https://doi.org/10.5455/annalsmedres.2019.01.025