Karma yoğun bakımda takip edilen kritik hastalarda platelet indekslerinin prognostik değeri
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Dosyalar
Tarih
2020
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Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Trombosit indeksleri (TİN), trombositlerin morfolojisi ve fonksiyonları hakkında bilgi veren biyolojik belirteçlerdir. Kritik hastalarda ise TİN’leri hastalık s?iddet ve prognozuyla ilis?kilendiren az sayıda çalıs?ma vardır. Çalıs?mamızda trombosit sayı ve fonksiyonlarını etkileyebilecek pek çok etkenin maruziyeti altında olan YBU? hastalarında, rutin olarak çalıs?ılan trombosit indekslerinin klinik o?nemini ve mortaliteyi o?ngo?rmedeki bas?arısını deg?erlendirmeyi amaçladık. 01 Ocak 2016- 31 Aralık 2016 tarihleri arasında 10 yataklı u?çu?ncu? basamak karma YBU?’de takip edilen 347 hastadan TİN’leri o?lçu?lebilen 314 hastanın demografik o?zellikleri ve klinik takip verileri geriye yönelik olarak incelendi. Hastaların 194’u? (%62) erkek, yas? ortalaması 62.7 ± 16.9 (19-86), APACHE II hastalık s?iddet skor ortalaması 18.9 ± 8.5, ortalama yatıs? su?resi (OYS) 9.1 (1-182) gün ve mortalite %43 saptanmıs?tır. Ortalama trombosit hacmi (MPV) ve trombosit dag?ılım genis?lig?i (PDW) indekslerinin birbirleriyle korele oldug?u; bununla birlikte hastalık s?iddeti ile pozitif, trombosit sayısı ile negatif korelasyon go?sterdikleri tespit edilmis?tir. Erkek cinsiyette MPV ve PDW du?s?u?k, plateletcrit (PCT) yu?ksek ve mortalite oranı nispeten du?s?u?k gerçekles?mis?tir (%37.6<%44.1) (p<0,01). Genel hasta popu?lasyonuna bakıldıg?ında ise PDW ve trombosit deg?erlerinin mortalite artıs?ı ile ilis?kili oldug?u go?zlenmis?, aynı zamanda PCT <0.17 altında oldug?unda >0,32’nin olanlara go?re mortalite riskini iki kat arttıg?ı tespit edilmis?tir. PDW/PLT oranı ve PDW/PCT oranlarının her ikisi de mortaliteyle korele (p<0.001, p<0.001) olsa da spesivite ve sensiviteleri yeterli deg?ildi (r:0,11, r:0,10). Trombosit indekslerinden PDW ve PCT’nin karma yog?un bakım u?nitelerinde, trombosit du?zeyi gibi hastalık s?iddetini tanımlayan skorlama sistemlerine dahil edilebilecek, prognostik biyo-belirteçler oldug?u kanaatine varıldı.
Thrombocyte indexes (TIN) are biological markers of thrombocyte morphology and function. In critical patients, few studies evaluated TIN relation with disease severity and prognosis. In this study, we objected to evaluate TIN as a routine feasible parameter at respect of clinical significance to predicting mortality, even though thrombocyte count and functions were prone to alter by variable conditions of critical care unit patients. Data of 314 patients those with objected parameters out of 347 retrospectively evaluated for TIN relation with clinical surveillance and demographics, in a ten bed capacity mixed-type tertiary CCU in between Jan 1 st – 31 st Dec 2016. Patients’, 194 male (62%), mean age was 62.7 ± 16.9 (19-86) and APACHE II score was 18.9 ± 8.5, mean length of stay (LOS) was 9.1 (1-182) days and with 43% mortality. The mean thrombocyte volume (MPV) and dispersion width (PDW) indexes were both correlated each other and positively with disease severity, on the other hand negatively with thrombocyte count. The higher plateletcrit (PCT) levels otherwise lower MPV and PDW were found in males, and also showed relatively lower mortality rates (37.6%<44.1%) (p<0.01). PDW and thrombocyte count were related to increased mortality, while as PCT<0.17 levels were associated with 2x mortality risk according to PCT>0.32. Both PDW/PLT and PDW/PCT ratios related to mortality too (p<0.001, p<0.001), otherwise with relatively lower coefficients (r: 0,11, r: 0,10). TIN in mixed type CCUs was assumed as PDW and PCT could be included to disease severity scoring system prognostic biomarkers, like thrombocyte counts.
Thrombocyte indexes (TIN) are biological markers of thrombocyte morphology and function. In critical patients, few studies evaluated TIN relation with disease severity and prognosis. In this study, we objected to evaluate TIN as a routine feasible parameter at respect of clinical significance to predicting mortality, even though thrombocyte count and functions were prone to alter by variable conditions of critical care unit patients. Data of 314 patients those with objected parameters out of 347 retrospectively evaluated for TIN relation with clinical surveillance and demographics, in a ten bed capacity mixed-type tertiary CCU in between Jan 1 st – 31 st Dec 2016. Patients’, 194 male (62%), mean age was 62.7 ± 16.9 (19-86) and APACHE II score was 18.9 ± 8.5, mean length of stay (LOS) was 9.1 (1-182) days and with 43% mortality. The mean thrombocyte volume (MPV) and dispersion width (PDW) indexes were both correlated each other and positively with disease severity, on the other hand negatively with thrombocyte count. The higher plateletcrit (PCT) levels otherwise lower MPV and PDW were found in males, and also showed relatively lower mortality rates (37.6%<44.1%) (p<0.01). PDW and thrombocyte count were related to increased mortality, while as PCT<0.17 levels were associated with 2x mortality risk according to PCT>0.32. Both PDW/PLT and PDW/PCT ratios related to mortality too (p<0.001, p<0.001), otherwise with relatively lower coefficients (r: 0,11, r: 0,10). TIN in mixed type CCUs was assumed as PDW and PCT could be included to disease severity scoring system prognostic biomarkers, like thrombocyte counts.
Açıklama
Anahtar Kelimeler
Trombosit İndeksleri, Ortalama Trombosit Hacmi, Trombosit Dağılım Genişliği, Plateletcrit, Platelet Indexes, Mean Platelet Volume, Platelet Dispersion Width, Platelecrit
