scholarly journals Biomarkers of Inflammation and Inflammation-Related Indexes upon Emergency Department Admission Are Predictive for the Risk of Intensive Care Unit Hospitalization and Mortality in Acute Poisoning: A 6-Year Prospective Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Catalina Lionte ◽  
Cristina Bologa ◽  
Victorita Sorodoc ◽  
Ovidiu Rusalim Petris ◽  
Gabriela Puha ◽  
...  
Keyword(s):  
Emergency Department ◽  
Predictive Accuracy ◽  
Demographic Data ◽  
Screening Tools ◽  
Multivariate Logistic Regression Model ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
Hs Crp

Patients poisoned with drugs and nonpharmaceutical substances are frequently admitted from the emergency department (ED) to a medical or ICU department. We hypothesized that biomarkers of inflammation and inflammation-related indexes based on the complete blood cell (CBC) count can identify acutely poisoned patients at increased risk for ICU hospitalization and death. We performed a 6-year prospective cohort study on 1548 adult patients. The demographic data, the levels of hs-CRP (high-sensitivity C-reactive protein), CBC, and inflammation-related indexes based on CBC counts were collected upon admission and compared between survivors and nonsurvivors, based on the poison involved. Both a multivariate logistic regression model with only significant univariate predictors and a model including univariate predictors plus each log-transformed inflammation-related indexes for mortality were constructed. The importance of the variables for mortality was graphically represented using the nomogram. hs-CRP (odds ratio (OR), 1.38; 95% CI, 1.16–1.65, p < 0.001 for log-transformed hs-CRP), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were significantly associated with the risk of ICU hospitalization, after multivariable adjustment. Only RDW, NLR, and monocyte-lymphocyte ratio (MLR) were significantly associated with mortality. The predictive accuracy for mortality of the models which included either NLR (AUC 0.917, 95% CI 0.886-0.948) or MLR (AUC 0.916, 95% CI 0.884-0.948) showed a high ability for prognostic detection. The use of hs-CRP, RDW, NLR, and MLR upon ED admission are promising screening tools for predicting the outcomes of patients acutely intoxicated with undifferentiated poisons.

scholarly journals The role of monocyte to high-density lipoprotein cholesterol ratio in prediction of increased systemic inflammation and the risk of cardiovascular disease in endometriosis

2021 ◽  
Vol 38 (2) ◽  
pp. 106-110
Author(s):  
İsmail BIYIK ◽  
Fatih KESKİN ◽  
Nagihan SAZ
Keyword(s):  
Systemic Inflammation ◽  
Demographic Data ◽  
Hdl Cholesterol ◽  
Reproductive Age ◽  
Prognostic Indicators ◽  
Control Group ◽  
Distribution Width ◽  
Cholesterol Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Endometriosis occurs in about 5-10 in 100 women of reproductive age. The pathophysiology of endometriosis is controversial. Some studies claimed an association between endometriosis and increased levels of inflammatory factors in peritoneal fluid and/or peripheral blood. Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are inflammatory markers and are used as predictors and prognostic indicators of mortality and morbidity in many diseases. In this study, we aimed to investigate whether Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are increased in endometriosis as in patients with chronic inflammation and cardiovascular diseases. This is a retrospective case-control study conducted with 87 women, 45 in the endometriosis group and 42 in the control group. The demographic data, biochemical, complete blood count parameters and lipid profile of the cases were recorded and compared between the groups. The mean age of the endometriosis group was 33.88 years and was older than the control group. In terms of other demographic data, there were no difference between the two groups. Although the platelet distribution width and triglyceride values of the endometriosis group were higher than controls, they were interpreted as clinically insignificant. There were no significant differences between the groups in terms of other laboratory parameters including MHR and NLR. In this study, MHR and NLR are found similar in endometriosis and control groups. Further studies are needed to investigate the relationship between increased systemic inflammation.

scholarly journals Systemic inflammatory response markers in preeclampsia

2018 ◽  
Vol 10 (03) ◽  
pp. 316-319 ◽  
Author(s):  
Ersin Çintesun ◽  
Feyza Nur Incesu Çintesun ◽  
Huriye Ezveci ◽  
Fikret Akyürek ◽  
Çetin Çelik
Keyword(s):  
Inflammatory Response ◽  
Demographic Data ◽  
Systemic Inflammatory Response ◽  
Control Group ◽  
Retrospective Case ◽  
Multicenter Studies ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pregnant Females

ABSTRACT PURPOSE: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), platelet distribution width (PDW), red cell distribution width (RDW), mean platelet volume (MPV), and plateletcrit (PCT) are known as systemic inflammatory response markers. In this study, we aimed to evaluate changes in NLR, PLR, PDW, RDW, MPV, and PCT in preeclampsia (PE) and their use in predicting its severity. MATERIALS AND METHODS: This is a retrospective case–control study. The study comprised 64 control group (healthy pregnant females), 51 females with mild PE, and 13 with severe PE. These three groups were compared with demographic data and inflammation markers. RESULTS: There were no statistically significant differences between healthy pregnant females and preeclaptic females in terms of median age, hemoglobin, lymphocyte, neutrophil, platelet, NLR, PLR, PDV, RDW, MPV, PCT (P > 0.05). The control group has a higher number of gravity and parity than the PE group (P < 0.001). MPV value is a lower PE group than the control group (P < 0.001). Both gravity and parity were significantly higher in the patients with mild PE than in the control group (P < 0.001). MPV value was statistically higher in the control group compared both mild and severe PE (P < 0.001), however, no statistical difference between mild and severe PE (P = 0.305). CONCLUSIONS: MPV may be clinically useful markers in the prediction of PE. Further, prospective multicenter studies are needed to reveal the association between these markers and PE.

Blood Cell Parameters and Predicting Coronary In-Stent Restenosis

Angiology ◽  
2019 ◽  
Vol 70 (8) ◽  
pp. 711-718 ◽  
Author(s):  
Zhichao Wang ◽  
Chi Liu ◽  
Hong Fang
Keyword(s):  
Blood Cell ◽  
Platelet Activation ◽  
Blood Cells ◽  
Inflammatory Marker ◽  
Distribution Width ◽  
Cell Parameters ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Stent Restenosis ◽  
In Stent Restenosis

Major advances in coronary interventional techniques and pharmacotherapy as well as the use of drug-eluting stents (DESs) have considerably reduced the risk of in-stent restenosis (ISR). However, ISR remains a major clinical challenge. Inflammation and platelet activation are important processes that underlie the pathophysiology of ISR. Parameters related to blood cells, entailing both cell count and morphology, are useful markers of the inflammatory response and platelet activation in clinical practice. Recent studies have highlighted several new combined or derived parameters related to blood cells that independently predict ISR after DES implantation. The neutrophil/lymphocyte ratio, an inflammatory marker, is regarded as a predictor of the risk of ISR and the stability of atherosclerotic plaques. The mean platelet volume, a widely used platelet activation parameter, has been shown to be a predictor of the risk of ISR and the efficacy of antiplatelet therapy. Other markers considered include the platelet/lymphocyte ratio, red blood cell distribution width, and platelet distribution width. This review provides an overview of these parameters that may help stratify the risk of coronary angiographic and clinical outcomes related to ISR.

Lymphopenia and risk for long-term mortality among patients undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Zafrir ◽  
R Jaffe ◽  
H Sliman ◽  
O Barnett-Griness ◽  
W Saliba
Keyword(s):  
Coronary Angiography ◽  
Mortality Risk ◽  
Predictive Accuracy ◽  
Cohort Analysis ◽  
Cox Proportional Hazards ◽  
Cross Sectional ◽  
Distribution Width ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Lymphopenia has been shown to be associated with adverse prognosis in chronic disease states that are related to immune dysregulation. Purpose We aimed to determine the association between lymphopenia and all-cause mortality in patients presenting to coronary angiography with or without acute coronary syndromes (ACS). We also investigated whether elevated red blood cell distribution width (RDW), an established cardiovascular prognostic marker, further refines risk stratification and improves predictive accuracy beyond lymphocytes count. Methods Retrospective cohort analysis of patients undergoing coronary angiography for evaluation or treatment of coronary artery disease between 2003 and 2018. Long-term mortality risk associated with relative (1000–1500 /μL) or severe (&lt;1000 /μL) lymphopenia was analyzed using Cox proportional hazards regression models, adjusting for comorbidities, ACS and RDW. Results Overall, 15179 patients underwent coronary angiography, at a mean age of 65±12 years. On cross-sectional analysis, lymphopenia was associated with kidney disease, cancer, heart failure and presentation with ACS, but lower rates of smoking and obesity. During a median follow-up of 7 (IQR 3.5–11.5) years, 4253 patients died. Compared to normal lymphocytes count (1500–5000 /μL), the multivariable adjusted hazard ratio (HR) (95% confidence interval) for mortality was 1.31 (1.21–1.41) and 1.97 (1.75–2.22) for relative and severe lymphopenia, respectively. The increase in mortality associated with severe lymphopenia was significant in patients presenting with non-ACS [HR 2.18 (1.74–2.73)], ST-segment elevation myocardial infarction (STEMI) [HR 1.59 (1.15–2.21)], or unstable angina/non-STEMI [HR 2.00 (1.70–2.34)]; p-for-interaction 0.626. The association of lymphopenia with mortality remained significant after additional adjustment to RDW. High RDW (&gt;14.5%) was associated with increased mortality risk in each of the lymphocytes count groups, and improved the predictive accuracy with AUC increase from 0.609 (0.601–0.616) to 0.646 (0.639–0.654) (p&lt;0.001). Conclusions Lymphopenia is associated with increased risk for long-term mortality in patients undergoing coronary angiography, regardless of coronary presentation. High RDW may enhance the predictive ability of lymphopenia. Lymphocyte count and mortality risk Funding Acknowledgement Type of funding source: None

Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Esin Merve Erol Koç ◽  
Rahime Bedir Fındık ◽  
Hatice Akkaya ◽  
Işılay Karadağ ◽  
Eda Özden Tokalıoğlu ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Monocyte Count ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

Prediction of Troponin elevation in Non- ST Acute Coronary Syndrome Patients presenting to The Emergency Department Using Neutrophil-lymphocyte ratio

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sarah Mohamed Mahmoud ◽  
Bassam Sobhy ◽  
Ramy Raymond
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Complete Blood Count ◽  
P Value ◽  
Troponin Elevation ◽  
Positive Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome

Abstract Background The neutrophil–lymphocyte ratio (NLR) is considered an independent predictor of mortality and myocardial infarction (MI) in stable coronary artery disease (SCAD). Also NLR have prognostic value in patients with acute coronary syndromes (ACSs). However the diagnostic power of NLR in patients suspected of ACS is still under study Objective is to determine the ability of neutrophil-lymphocyte ratio to predict troponin elevation in patients presenting to emergency department with acute coronary syndrome Material and Methods From June 2018 to March 2019, 100 patients were enrolled who presented to the ER with NST-ACS. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. Baseline Complete blood count with calculation of NLR is done Results The study population was divided into 2 groups: troponin- negative group (n = 50) and troponin-positive group (n = 50). Mean age was 55.8 ± 11.3. 77% of the patients were male. No significance difference in the level of hemoglobin, WBCs and platelets between the 2 groups. The neutrophil count was significantly higher in the troponin-positive group (p &lt; 0.001). The median admission. NLR was significantly higher in the troponin-positive group (2 vs. 3.9, P &lt; 0.001). A cutoff point of 3.4 for NLR measured on admission had 84% sensitivity and 84% specificity in predicting follow-up troponin positivity. A highly significant correlation was found between NLR and level of troponin change (p value &lt;0.01) Conclusion NLR can be used as a diagnostic tool in the differentiation of patients with acute coronary syndrome. NLR is a non-expensive, simple and available parameter that can be used in diagnosis of NSTEMI.

scholarly journals What are the Most Effective Factors in Determining Future Exacerbations, Morbidity Weight and Mortality In Patients Hospitalized wıth COPD Attack? A Prospective Study

2021 ◽  
Author(s):  
Çağla Koç ◽  
Füsun Şahin
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Blood Gases ◽  
Distribution Width ◽  
Factors Affecting ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Arterial Blood ◽  
Gold Stage ◽  
A Prospective Study

INTRODUCTION: The aim of this study was to investigate the important factors affecting the COPD prognosis. MATERIAL AND METHODS: We included 160 hospitalized patients with COPD exacerbation in the study. Hemoglobin-HB, hematocrit-HCT, leukocyte, red cell distribution width- RDW, mean platelet volume, platelet distribution width, plateletcrit, platelet, neutrophil / lymphocyte ratio, platelet / lymphocyte ratio, eosinophil, uric acid, albumin, CRP, procalcitonin, arterial blood gases (PO2, PCO2) pulmonary function test (FEV1, FVC), echocardiography (ejection fraction-EF) GOLD stage, MMRC and BORG scales, Charlson comorbidity index, body mass index-BMI, length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit-ICU, and mortality during the 6 months after discharge were evaluated. RESULTS: High CRP and procalcitonin values were observed in the group with long hospital stay. In mortality group, HB, HCT, BMI and PO2 values were significantly lower than the group without mortality while age and GOLD stage were higher. The age, BORG and MMRC scores, number of exacerbations experienced in the previous 1 year, RDW, eosinophil count, PCO2 were significantly higher in the ICU group than without ICU. HCT, EF values were lower in the ICU group than without ICU. FEV1, FVC values were significantly lower in follow-up attack group than without attack; the duration of COPD and the number of experienced in the previous 1 year were high. CONCLUSION: It has been concluded that the scoring combining selected biomarkers and other factors will be stronger in determining the prognosis.

scholarly journals Serum S100A8 as an early diagnostic biomarker in patients with community-acquired pneumonia

2020 ◽  
Author(s):  
Ling Zheng ◽  
Jun Fei ◽  
Zheng Xu ◽  
Chun-Mei Feng ◽  
Se-Ruo Li ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Inflammatory Cytokines ◽  
Demographic Data ◽  
A549 Cells ◽  
Community Acquired Pneumonia ◽  
Diagnostic Biomarker ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severity Scores

Abstract Background and Objectives Limited studies suggested that calprotectin may take part in the pathophysiology of community-acquired pneumonia (CAP). Nevertheless, there is no clinical study to analyze the role of S100A8 in CAP patients. The objective of this study was to analyze the association of serum S100A8 with the severity of CAP based on a cross-sectional study. Methods Entire 200 CAP patients and 100 normal subjects were recruited. Demographic data, clinical information and serum were collected on admission. Serum S100A8 and inflammatory cytokines were detected. Results Serum S100A8 was increased in CAP patients on admission. Serum S100A8 was gradually increased in parallel with the CAP severity scores. Serum S100A8 was positively correlated with CAP severity scores (CURB-65, CRB-65, PSI, CURXO and SMART-COP), blood routine parameters (WBC, neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio) and inflammatory cytokines (TNFα, IL-1β and CRP). Furtherly, univariate and multivariate logistical regression analysis revealed that there was a positive association between serum S100A8 with CRB-65, PSI and CURXO. Moreover, the predictive capacity of serum S100A8 was performed by receiver operating characteristic area under the curve (AUC) analysis. The AUCs of S100A8 for CAP and CAP severity were 0.855 and 0.893, respectively. Mechanistic analysis found that S100A8 knockdown alleviated streptococcus pneumoniae-evoked inflammatory cytokines in A549 cells. Conclusion Serum S100A8 on admission was positively associated with the severity of CAP. S100A8 knockdown alleviates streptococcus pneumoniae- evoked inflammatory cytokines in A549 cells, indicating that S100A8 may exert an important role in the pathophysiology of CAP and be an early serum diagnostic biomarker for CAP.

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