Neutrophil/lymphocyte ratio as a predictor of mortality among aortic dissection patients in the emergency department/ Acil servise basvuran aort diseksiyonu hastalarinda mortalitenin belirleyicisi olarak notrofil/lenfosit orani
BACKGROUND: Aortic dissection (AD) is a serious cardiovascular condition associated with high mortality rates. The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker. MET...
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| Veröffentlicht in: | Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 2024-09, Vol.30 (9), p.644 |
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| description | BACKGROUND: Aortic dissection (AD) is a serious cardiovascular condition associated with high mortality rates. The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker. METHODS: This retrospective cohort study included 103 patients diagnosed with AD and treated in the emergency department between 2018 and 2023. Patient demographics, clinical features, and laboratory results were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounders such as age, mean systolic blood pressure, oxygen saturation, hemoglobin, lactate values, and the presence of coronary artery disease. The ability of NLR to predict mortality was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The study population was divided into two groups: non-survivors (68% mortality rate) and survivors (32% survival rate). The non-survivor group had significantly higher NLR values compared to the survivor group (median NLR 7.66 vs. 2.5, p |
| doi_str_mv | 10.14744/tjtes.2024.78241 |
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The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker. METHODS: This retrospective cohort study included 103 patients diagnosed with AD and treated in the emergency department between 2018 and 2023. Patient demographics, clinical features, and laboratory results were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounders such as age, mean systolic blood pressure, oxygen saturation, hemoglobin, lactate values, and the presence of coronary artery disease. The ability of NLR to predict mortality was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The study population was divided into two groups: non-survivors (68% mortality rate) and survivors (32% survival rate). The non-survivor group had significantly higher NLR values compared to the survivor group (median NLR 7.66 vs. 2.5, p<0.001). Multivariate logistic regression analysis identified NLR as an independent predictor of in-hospital mortality (adjusted odds ratio [OR] 2.33, 95% confidence interval [CI] 1.42-3.82, p<0.001). ROC analysis for NLR demonstrated high discriminative power with an area under the ROC curve (AUROC) of 0.851 (95% CI 0.768-0.914). The determined cut- off point was >5.08 with a sensitivity of 77.14% and specificity of 81.82%. CONCLUSION: The findings indicate that high NLR is strongly associated with increased mortality risk in patients with AD and can be used in emergency clinical settings to predict mortality. Keywords: Aortic dissection; mortality; neutrophil-to-lymphocyte ratio. AMAC: Aort diseksiyonu (AD), yuksek mortalite oranlariyla iliskili ciddi bir kardiyovaskuler durumdur. Sistemik enflamatuvar yanit AD'nin prognozunu etkileyebilir ve bu baglamda notrofil-lenfosit orani (NLR) basit ve hizli bir enflamatuvar biyobelirtec olarak ortaya cikmaktadir. GEREC VE YONTEM: Bu retrospektif kohort calismaya 2018-2023 yillari arasinda AD tanisi konulan ve acil serviste tedavi goren 103 hasta alindi. Hastalarin demografik ozellikleri, klinik ozellikleri ve laboratuvar sonuclari degerlendirildi. Yas, ortalama sistolik kan basinci, oksijen doygunlugu, hemoglobin, laktat degerleri ve koroner arter hastaliginin varligi gibi potansiyel karistiricilari ayarlamak icin cok degiskenli lojistik regresyon analizi yapildi. NLR'nin mortaliteyi tahmin etme yetenegi, alici isletim karakteristigi (ROC) analizi kullanilarak analiz edildi. BULGULAR: Calisma populasyonu iki gruba ayrildi: Hayatta kalmayanlar (%68 olum orani) ve hayatta kalanlar (%32 hayatta kalma orani). Hayatta kalmayan grup, hayatta kalan gruba kiyasla anlamli derecede daha yuksek NLR degerlerine sahipti (medyan NLR 7.66'ya karsi 2.5, p<0.001). Cok degiskenli lojistik regresyon analizi, NLO'yu hastane ici mortalitenin bagimsiz bir belirleyicisi olarak tanimladi (duzeltilmis OR 2.33, %95 GA 1.42- 3.82, p<0.001). NLR icin ROC analizi, ROC egrisi altindaki alan (AUROC) 0.851 (%95 GA 0.768-0.914) ile yuksek ayirt edici guc gosterdi. Belirlenen kesme noktasi >5.08 olup duyarliligi %77.14, ozgullugu %81.82 idi. SONUC: Bulgular, yuksek NLR'nin AD'li hastalarda artan mortalite riskiyle guclu bir sekilde iliskili oldugunu ve acil klinik ortamlarda mortaliteyi tahmin etmek icin kullanilabilecegini gostermektedir. Anahtar sozcukler: Aort diseksiyonu; mortalite; notrofil-lenfosit orani.</description><identifier>ISSN: 1306-696X</identifier><identifier>DOI: 10.14744/tjtes.2024.78241</identifier><language>eng</language><publisher>KARE Publishing</publisher><subject>Advertising executives ; Coronary heart disease ; Dissecting aneurysm ; Glycosylated hemoglobin ; Lactates ; Lymphocytes ; Medical research ; Medicine, Experimental ; Mortality ; Patient outcomes ; Prognosis ; Surgery ; Taiwan</subject><ispartof>Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2024-09, Vol.30 (9), p.644</ispartof><rights>COPYRIGHT 2024 KARE Publishing</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27902,27903</link.rule.ids></links><search><creatorcontrib>Ustaalioglu, Izzet</creatorcontrib><creatorcontrib>Umac, Gulbin Aydogdu</creatorcontrib><title>Neutrophil/lymphocyte ratio as a predictor of mortality among aortic dissection patients in the emergency department/ Acil servise basvuran aort diseksiyonu hastalarinda mortalitenin belirleyicisi olarak notrofil/lenfosit orani</title><title>Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES</title><description>BACKGROUND: Aortic dissection (AD) is a serious cardiovascular condition associated with high mortality rates. The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker. METHODS: This retrospective cohort study included 103 patients diagnosed with AD and treated in the emergency department between 2018 and 2023. Patient demographics, clinical features, and laboratory results were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounders such as age, mean systolic blood pressure, oxygen saturation, hemoglobin, lactate values, and the presence of coronary artery disease. The ability of NLR to predict mortality was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The study population was divided into two groups: non-survivors (68% mortality rate) and survivors (32% survival rate). The non-survivor group had significantly higher NLR values compared to the survivor group (median NLR 7.66 vs. 2.5, p<0.001). Multivariate logistic regression analysis identified NLR as an independent predictor of in-hospital mortality (adjusted odds ratio [OR] 2.33, 95% confidence interval [CI] 1.42-3.82, p<0.001). ROC analysis for NLR demonstrated high discriminative power with an area under the ROC curve (AUROC) of 0.851 (95% CI 0.768-0.914). The determined cut- off point was >5.08 with a sensitivity of 77.14% and specificity of 81.82%. CONCLUSION: The findings indicate that high NLR is strongly associated with increased mortality risk in patients with AD and can be used in emergency clinical settings to predict mortality. Keywords: Aortic dissection; mortality; neutrophil-to-lymphocyte ratio. AMAC: Aort diseksiyonu (AD), yuksek mortalite oranlariyla iliskili ciddi bir kardiyovaskuler durumdur. Sistemik enflamatuvar yanit AD'nin prognozunu etkileyebilir ve bu baglamda notrofil-lenfosit orani (NLR) basit ve hizli bir enflamatuvar biyobelirtec olarak ortaya cikmaktadir. GEREC VE YONTEM: Bu retrospektif kohort calismaya 2018-2023 yillari arasinda AD tanisi konulan ve acil serviste tedavi goren 103 hasta alindi. Hastalarin demografik ozellikleri, klinik ozellikleri ve laboratuvar sonuclari degerlendirildi. Yas, ortalama sistolik kan basinci, oksijen doygunlugu, hemoglobin, laktat degerleri ve koroner arter hastaliginin varligi gibi potansiyel karistiricilari ayarlamak icin cok degiskenli lojistik regresyon analizi yapildi. NLR'nin mortaliteyi tahmin etme yetenegi, alici isletim karakteristigi (ROC) analizi kullanilarak analiz edildi. BULGULAR: Calisma populasyonu iki gruba ayrildi: Hayatta kalmayanlar (%68 olum orani) ve hayatta kalanlar (%32 hayatta kalma orani). Hayatta kalmayan grup, hayatta kalan gruba kiyasla anlamli derecede daha yuksek NLR degerlerine sahipti (medyan NLR 7.66'ya karsi 2.5, p<0.001). Cok degiskenli lojistik regresyon analizi, NLO'yu hastane ici mortalitenin bagimsiz bir belirleyicisi olarak tanimladi (duzeltilmis OR 2.33, %95 GA 1.42- 3.82, p<0.001). NLR icin ROC analizi, ROC egrisi altindaki alan (AUROC) 0.851 (%95 GA 0.768-0.914) ile yuksek ayirt edici guc gosterdi. Belirlenen kesme noktasi >5.08 olup duyarliligi %77.14, ozgullugu %81.82 idi. SONUC: Bulgular, yuksek NLR'nin AD'li hastalarda artan mortalite riskiyle guclu bir sekilde iliskili oldugunu ve acil klinik ortamlarda mortaliteyi tahmin etmek icin kullanilabilecegini gostermektedir. Anahtar sozcukler: Aort diseksiyonu; mortalite; notrofil-lenfosit orani.</description><subject>Advertising executives</subject><subject>Coronary heart disease</subject><subject>Dissecting aneurysm</subject><subject>Glycosylated hemoglobin</subject><subject>Lactates</subject><subject>Lymphocytes</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Taiwan</subject><issn>1306-696X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNptj89OHDEMxudQpCLgAXqz1PPuJpPMv-MKtYCE2guH3pAncXYNM8koySLN8_IihBZVPVQ-WJa_7_fZVfVFiq3Unda7_JQpbWtR623X11p-qs6lEu2mHdpfn6urlJ6EEFKqQcnuvHr9Qaccw3LkaTet83IMZs0EETMHwAQISyTLJocIwcEcYsaJ8wo4B38ALDMbsJwSmWLxsBQn-ZyAPeQjAc0UD-TNCpYWjHkuyx3sDU-QKL5wIhgxvZwi-t-0dxY9J16DP8ERU4nDyN7i32zyBT3SxHGilQ0nhlA0-Aw-lFfc-yfkXUicIRQsX1ZnDqdEVx_9onr4_u3h-nZz__Pm7np_vzm0ndoYakZpRqkb19dWKdtILcxg0QwOB9H2KBoSWrV937q2V27oGoGqw6G2btSduqi-_sEecKJHLhfkiGbmZB73vZSi67VURbX9j6qUpZlN8FTup38Nb4almho</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Ustaalioglu, Izzet</creator><creator>Umac, Gulbin Aydogdu</creator><general>KARE Publishing</general><scope/></search><sort><creationdate>20240901</creationdate><title>Neutrophil/lymphocyte ratio as a predictor of mortality among aortic dissection patients in the emergency department/ Acil servise basvuran aort diseksiyonu hastalarinda mortalitenin belirleyicisi olarak notrofil/lenfosit orani</title><author>Ustaalioglu, Izzet ; Umac, Gulbin Aydogdu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g673-ce5b1cb145f82d33d5140c9dac9fa9068a05e0436886f683f9750a37a92dfb473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Advertising executives</topic><topic>Coronary heart disease</topic><topic>Dissecting aneurysm</topic><topic>Glycosylated hemoglobin</topic><topic>Lactates</topic><topic>Lymphocytes</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Taiwan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ustaalioglu, Izzet</creatorcontrib><creatorcontrib>Umac, Gulbin Aydogdu</creatorcontrib><jtitle>Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ustaalioglu, Izzet</au><au>Umac, Gulbin Aydogdu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil/lymphocyte ratio as a predictor of mortality among aortic dissection patients in the emergency department/ Acil servise basvuran aort diseksiyonu hastalarinda mortalitenin belirleyicisi olarak notrofil/lenfosit orani</atitle><jtitle>Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES</jtitle><date>2024-09-01</date><risdate>2024</risdate><volume>30</volume><issue>9</issue><spage>644</spage><pages>644-</pages><issn>1306-696X</issn><abstract>BACKGROUND: Aortic dissection (AD) is a serious cardiovascular condition associated with high mortality rates. The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker. METHODS: This retrospective cohort study included 103 patients diagnosed with AD and treated in the emergency department between 2018 and 2023. Patient demographics, clinical features, and laboratory results were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounders such as age, mean systolic blood pressure, oxygen saturation, hemoglobin, lactate values, and the presence of coronary artery disease. The ability of NLR to predict mortality was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The study population was divided into two groups: non-survivors (68% mortality rate) and survivors (32% survival rate). The non-survivor group had significantly higher NLR values compared to the survivor group (median NLR 7.66 vs. 2.5, p<0.001). Multivariate logistic regression analysis identified NLR as an independent predictor of in-hospital mortality (adjusted odds ratio [OR] 2.33, 95% confidence interval [CI] 1.42-3.82, p<0.001). ROC analysis for NLR demonstrated high discriminative power with an area under the ROC curve (AUROC) of 0.851 (95% CI 0.768-0.914). The determined cut- off point was >5.08 with a sensitivity of 77.14% and specificity of 81.82%. CONCLUSION: The findings indicate that high NLR is strongly associated with increased mortality risk in patients with AD and can be used in emergency clinical settings to predict mortality. Keywords: Aortic dissection; mortality; neutrophil-to-lymphocyte ratio. AMAC: Aort diseksiyonu (AD), yuksek mortalite oranlariyla iliskili ciddi bir kardiyovaskuler durumdur. Sistemik enflamatuvar yanit AD'nin prognozunu etkileyebilir ve bu baglamda notrofil-lenfosit orani (NLR) basit ve hizli bir enflamatuvar biyobelirtec olarak ortaya cikmaktadir. GEREC VE YONTEM: Bu retrospektif kohort calismaya 2018-2023 yillari arasinda AD tanisi konulan ve acil serviste tedavi goren 103 hasta alindi. Hastalarin demografik ozellikleri, klinik ozellikleri ve laboratuvar sonuclari degerlendirildi. Yas, ortalama sistolik kan basinci, oksijen doygunlugu, hemoglobin, laktat degerleri ve koroner arter hastaliginin varligi gibi potansiyel karistiricilari ayarlamak icin cok degiskenli lojistik regresyon analizi yapildi. NLR'nin mortaliteyi tahmin etme yetenegi, alici isletim karakteristigi (ROC) analizi kullanilarak analiz edildi. BULGULAR: Calisma populasyonu iki gruba ayrildi: Hayatta kalmayanlar (%68 olum orani) ve hayatta kalanlar (%32 hayatta kalma orani). Hayatta kalmayan grup, hayatta kalan gruba kiyasla anlamli derecede daha yuksek NLR degerlerine sahipti (medyan NLR 7.66'ya karsi 2.5, p<0.001). Cok degiskenli lojistik regresyon analizi, NLO'yu hastane ici mortalitenin bagimsiz bir belirleyicisi olarak tanimladi (duzeltilmis OR 2.33, %95 GA 1.42- 3.82, p<0.001). NLR icin ROC analizi, ROC egrisi altindaki alan (AUROC) 0.851 (%95 GA 0.768-0.914) ile yuksek ayirt edici guc gosterdi. Belirlenen kesme noktasi >5.08 olup duyarliligi %77.14, ozgullugu %81.82 idi. SONUC: Bulgular, yuksek NLR'nin AD'li hastalarda artan mortalite riskiyle guclu bir sekilde iliskili oldugunu ve acil klinik ortamlarda mortaliteyi tahmin etmek icin kullanilabilecegini gostermektedir. Anahtar sozcukler: Aort diseksiyonu; mortalite; notrofil-lenfosit orani.</abstract><pub>KARE Publishing</pub><doi>10.14744/tjtes.2024.78241</doi></addata></record> |
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| ispartof | Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2024-09, Vol.30 (9), p.644 |
| issn | 1306-696X |
| language | eng |
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| source | PubMed Central; PubMed Central Open Access |
| subjects | Advertising executives Coronary heart disease Dissecting aneurysm Glycosylated hemoglobin Lactates Lymphocytes Medical research Medicine, Experimental Mortality Patient outcomes Prognosis Surgery Taiwan |
| title | Neutrophil/lymphocyte ratio as a predictor of mortality among aortic dissection patients in the emergency department/ Acil servise basvuran aort diseksiyonu hastalarinda mortalitenin belirleyicisi olarak notrofil/lenfosit orani |
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