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Effectiveness of laboratory tests in predicting pathologies on computed tomography in geriatric patients with abdominal pain Skip to content Yıl 2024, Cilt: 49 Sayı: 2, 278 – 286, 30.06.2024
Yaşar Çatal , Nazire Ülkü Kır , Sinan Genç , Ayça Koca , Müge Günalp , Onur Polat
https://doi.org/10.17826/cumj.1414439
Öz Amaç: Çalışmamız, karın ağrısı olan geriatrik hastaların abdominal bilgisayarlı tomografisindeki (BT) klinik olarak anlamlı patolojileri (CSPs) öngörmede laboratuvar testlerinin etkinliğini araştırmayı amaçladı. Gereç ve Yöntem: Çalışmamız retrospektif bir vaka kontrol çalışmasıdır. Karın ağrısı nedeniyle acil servise başvuran, abdominal BT çekilen ve 65 yaş ve üzerinde olan tüm hastalar çalışmaya dahil edildi. Laboratuvar test sonuçları, başvuru sırasında alınan kan tahlillerinden elde edildi. BT sonuçlarına göre hastalar “CSPs (+)” ve “CSPs (-)” olmak üzere iki gruba ayrıldı. Laboratuvar sonuçları ile CSPs arasındaki ilişki istatistiksel olarak analiz edildi. Bulgular: Çalışmaya 518 hasta dahil edildi. Hastaların %72,4’ünde BT’de CSPs (+) olduğu saptandı. Alkalen fosfataz (ALP), C-reaktif protein (CRP), beyaz kan hücreleri (WBC), trombosit, nötrofil ve nötrofil lenfosit oranı (NLR) değerleri CSPs (+) hastalarda istatistiksel olarak anlamlı derecede yüksekti. Testlerin optimal kesim değerleri WBC>10.75 (x10˄3/µL), CRP >150.5 (mg/L), NLR>4.4, ALP >92 (u/L) idi. Tüm testlerin receiver operating characteristic eğrisi altında kalan alanı 0.6’nın altındaydı ve tanısal kullanımda yeterli etkinlikte değildi. Sonuç: Çalışmamız, karın ağrısı olan geriatrik hastalarda laboratuvar parametresi kullanımının BT’deki CSPs’yi öngörmede tek başına yeterli olmayacağını gösterdi.
Anahtar Kelimeler Geriatrik, karın ağrısı, acil servis, tomografi, laboratuvar testleri
Etik Beyan Çalışma için Ankara Üniversitesi Etik Kuruldan onay alınmıştır.
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Jung SK, Rhee DY, Lee WJ, Woo SH, Seol SH, Kim DH et al. Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging Clin Exp Res. 2017;29:529-36. Destek S, Yabacı A, Abik YN, Gül VO, Değer KC. Predictive and prognostic value of L-lactate, D-dimer, leukocyte, C-reactive protein and neutrophil/lymphocyte ratio in patients with acute mesenteric ischemia. Ulus Travma Acil Cerrahi Derg. 2020;26:86-94. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Acad Emerg Med. 2013;20:1087-100. Kumar S, Maurya J, Kumar S, Patne SK, Dwivedi AND. A study of C-reactive protein and D-dimer in patients of appendicitis. J Family Med Prim Care. 2020;9:3492-5. Li H, Sun D, Sun D, Xiao Z, Zhuang J, Yuan C. The diagnostic value of coagulation indicators and inflammatory markers in distinguishing between strangulated and simple intestinal obstruction. Surg Laparosc Endosc Percutan Tech. 2021;31:750-5
Effectiveness of laboratory tests in predicting pathologies on computed tomography in geriatric patients with abdominal pain Yıl 2024, Cilt: 49 Sayı: 2, 278 – 286, 30.06.2024
Yaşar Çatal , Nazire Ülkü Kır , Sinan Genç , Ayça Koca , Müge Günalp , Onur Polat
https://doi.org/10.17826/cumj.1414439
Öz Purpose: Our study aimed to investigate the effectiveness of laboratory tests in predicting clinically significant pathologies (CSPs) on abdominal computed tomography (CT) in geriatric patients with abdominal pain. Materials and Methods: Our study is a retrospective case-control study. All patients who were admitted to the emergency department due to abdominal pain had an abdominal CT scan and were 65 years of age or older were included in the study. Laboratory test results were obtained from blood tests taken at the time of admission. According to CT results, patients were grouped into two groups: “CSPs (+)” or “CSPs (-)”. The relationship between laboratory results and CSPs was analyzed statistically. Results: Five hundred eighteen patients were included in the study. CSPs (+) were detected on CT in 72.4% of the patients. Alkaline phosphatase (ALP), C-reactive protein (CRP), white blood cells (WBC), platelet, neutrophil, and neutrophil-lymphocyte ratio (NLR) values were statistically significantly higher in CSPs (+) patients. The optimal cut-off values of the tests were WBC>10.75 (x10˄3/µL), CRP >150.5 (mg/L), NLR>4.4, ALP >92 (U/L). The area under the receiver operating characteristic curve of all of these tests was below 0.6 and was not sufficiently effective for diagnostic use. Conclusion: Our study showed that using laboratory parameters alone would not be sufficient to predict CSPs on CT in geriatric patients with abdominal pain.
Anahtar Kelimeler Geriatric, Abdominal pain, emergency service, tomography, laboratory tests
Etik Beyan Ethical approval was obtained from the Ankara University Faculty Of Medicine Clinical Research Ethics Board by its decision dated 29/05/2020 and numbered İ5- 290-20.
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Aliment Pharmacol Ther. 2009;29:1011-8. Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res. 2017;209:93-101. Yaow CYL, Chong RIH, Chan KS, Chia CTW, Shelat VG. Should Procalcitonin Be Included in Acute Cholecystitis Guidelines? A Systematic Review. Medicina. 2023;59:805. Meyer ZC, Schreinemakers JM, Mulder PG, Schrauwen L, de Waal RA, Ermens AAet al. Procalcitonin in the recognition of complications in critically ill surgical patients. J Surg Res. 2014;187:553-8. Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 2021;122:474-88. Tuncer AA, Cavus S, Balcioglu A, Silay S, Demiralp I, Calkan E et al. Can mean platelet volume, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, platelet-to-lymphocyte ratios be favourable predictors for the differential diagnosis of appendicitis. J Pak Med Assoc. 2019;69:647-54. Jung SK, Rhee DY, Lee WJ, Woo SH, Seol SH, Kim DH et al. Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging Clin Exp Res. 2017;29:529-36. Destek S, Yabacı A, Abik YN, Gül VO, Değer KC. Predictive and prognostic value of L-lactate, D-dimer, leukocyte, C-reactive protein and neutrophil/lymphocyte ratio in patients with acute mesenteric ischemia. Ulus Travma Acil Cerrahi Derg. 2020;26:86-94. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Acad Emerg Med. 2013;20:1087-100. Kumar S, Maurya J, Kumar S, Patne SK, Dwivedi AND. A study of C-reactive protein and D-dimer in patients of appendicitis. J Family Med Prim Care. 2020;9:3492-5. Li H, Sun D, Sun D, Xiao Z, Zhuang J, Yuan C. The diagnostic value of coagulation indicators and inflammatory markers in distinguishing between strangulated and simple intestinal obstruction. Surg Laparosc Endosc Percutan Tech. 2021;31:750-5 Toplam 31 adet kaynakça vardır.
Ayrıntılar Birincil Dil İngilizce Konular Acil Tıp, Geriatri ve Gerontoloji Bölüm Araştırma Yazarlar Yaşar Çatal Kayseri State Hospital 0000-0001-9322-0181 Türkiye
Nazire Ülkü Kır Diyadin State Hospital 0000-0001-8997-8811 Türkiye
Sinan Genç ANKARA UNIVERSITY, SCHOOL OF MEDICINE 0000-0002-0516-1028 Türkiye
Ayça Koca ANKARA UNIVERSITY, SCHOOL OF MEDICINE 0000-0002-1546-3150 Türkiye
Müge Günalp ANKARA UNIVERSITY, SCHOOL OF MEDICINE 0000-0001-8140-6720 Türkiye
Onur Polat ANKARA UNIVERSITY, SCHOOL OF MEDICINE 0000-0002-4850-8052 Türkiye
Yayımlanma Tarihi 30 Haziran 2024 Gönderilme Tarihi 10 Ocak 2024 Kabul Tarihi 29 Nisan 2024 Yayımlandığı Sayı Yıl 2024 Cilt: 49 Sayı: 2
Kaynak Göster MLA Çatal, Yaşar vd. “Effectiveness of Laboratory Tests in Predicting Pathologies on Computed Tomography in Geriatric Patients With Abdominal Pain”. Cukurova Medical Journal, c. 49, sy. 2, 2024, ss. 278-86, doi:10.17826/cumj.1414439.
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