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Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Due to the diagnostic challenges and dreadful consequences of delayed treatment of acute mesenteric ischemia (AMI), a variety of diagnostic markers have been previously studied. However, the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), which has been suggested to be a predictor of inflammation, has never been studied for AMI.

Methods

The data of 70 patients who underwent laparotomy (n = 8) and/or bowel resection (n = 62) for AMI (n = 70) between January 2009 and March 2014 were retrospectively analyzed. To investigate the studied parameters’ role in the differential diagnosis of AMI, control groups were selected from most common reasons of inflammation-related emergent surgery, acute appendicitis (AA, n = 62) and normal appendix (NA, n = 61). White blood cell (WBC), red cell distribution width (RDW), NLR and mean platelet volume (MPV) values were recorded. Outcome variables of the study were defined as diagnostic and prognostic role of NLR in AMI.

Results

RDW and NLR values were found to be higher in the AMI group than the AA group (p < 0.001 and p < 0.001). Also, WBC and MPV values were higher in the AMI group than the NA group (p = 0.001 and p < 0.001). Combined sensitivity, specificity, positive predictive value and negative predictive value of RDW and NLR for recommended cut-off values were 69.4, 71.2, 57.8 and 80.4 %, respectively.

Conclusion

High NLR value (>9.9) seems to be a valuable diagnostic marker of acute mesenteric ischemia. Combined use of NLR, RDW and other clinical assessment, could help the diagnosis of AMI, especially in the absence of advanced imaging modalities and expert radiologic interpretation.

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Conflict of interest

The conflict of interest statement: Recep Aktimur declares that he has no conflict of interest. Suleyman Cetinkunar declares that he has no conflict of interest. Kadir Yildirim declares that he has no conflict of interest. Sude Hatun Aktimur declares that she has no conflict of interest. Murat Ugurlucan declares that he has no conflict of interest. Nuraydin Ozlem declares that he has no conflict of interest.

Ethical approval

The study was approved by the institutional review board (2014/1, 01.10.2014).

Informed consent

Due to the retrospective nature of the study, informed consent was not obtained from included patients.

Author information

Authors and Affiliations

  1. Department of General Surgery, Samsun Education and Research Hospital, Ilkadim, Samsun, Turkey

    R. Aktimur, K. Yildirim & N. Ozlem

  2. Department of General Surgery, Adana Numune Education and Research Hospital, Adana, Turkey

    S. Cetinkunar

  3. Department of Hematology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    S. H. Aktimur

  4. Department of Cardiovascular Surgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey

    M. Ugurlucan

Authors
  1. R. Aktimur
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  2. S. Cetinkunar
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  3. K. Yildirim
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  4. S. H. Aktimur
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  5. M. Ugurlucan
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  6. N. Ozlem
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Correspondence to R. Aktimur.

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Aktimur, R., Cetinkunar, S., Yildirim, K. et al. Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia. Eur J Trauma Emerg Surg 42, 363–368 (2016). https://doi.org/10.1007/s00068-015-0546-4

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  • DOI: https://doi.org/10.1007/s00068-015-0546-4

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