.: ORİJİNAL ARAŞTIRMA
Pnömonili Çocukların Prognozunun Değerlendirilmesinde NLR, PLR, RDW ve HRR'nin Etkisi: Olgu-Kontrol Çalışması
Effect of NLR, PLR, RDW and HRR in the Evaluation of the Prognosis of Children with Pneumonia: Case-Control Study
Turkiye Klinikleri J Med Sci. 2023;43(4):343-9
doi: 10.5336/medsci.2023-99086
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Pnömoni, tüm dünyada çocuk ölümlerinin önde gelen sebeplerinden biridir. Çalışmamızda pnömonili çocukların prognozunu tahmin etmede tam kan sayımı [complete blood count (CBC)] parametrelerinin etkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Hastanemizde pnömoni tanısı almış 162 çocuk hasta retrospektif olarak incelendi. Hastalar; yoğun bakımda tedavi görenler (Grup I: ağır şiddette pnömoni, n=57), serviste tedavi görenler (Grup II: orta şiddette pnömoni, n=56) ve ayaktan tedavi ile iyileşenler (Grup III: hafif şiddette pnömoni, n=49) olarak 3 gruba ayrıldı ve hastaların herhangi bir tedavi almadan önce, ilk başvuru anındaki CBC parametreleri karşılaştırıldı. Bulgular: Grup I'deki hastaların eritrosit dağılım genişliği [red cell distribution width (RDW)], nötrofil/lenfosit oranı [neutrophil/lymphocyte ratio (NLR)] ve C-reaktif proteini (CRP) Grup II ve Grup III'teki hastalardan anlamlı şekilde yüksekti, hemoglobin/RDW oranı [hemoglobin/RDW ratio (HRR)] ise anlamlı şekilde düşüktü (p<0,001). Grup I'deki hastalarda RDW ve NLR'nin CRP ile pozitif korelasyon gösterdiği (sırasıyla r=0,637; p<0,001, r=0,705; p<0,001), HRR'nin ise CRP ile negatif korelasyon gösterdiği (r=0,562; p<0,001) saptandı. RDW, NLR, CRP ve bu değerlerin kombinasyonunun şiddetli pnömoni varlığını öngörmede yüksek duyarlılık (sırasıyla %89,5, %91,2, %86,0 ve %87,7) ve özgüllüğe (sırasıyla %86,7, %90,5, %86,7 ve %87,6) sahip oldukları saptandı, eğri altında kalan alanlar değerleri sırasıyla 0,944, 0,945, 0,938 ve 0,953 bulundu. Sonuç: Pnömoni tanısı alan çocuklarda RDW, NLR, HRR ve CRP prognozu tahmin etmede etkili parametrelerdir ve yoğun bakıma yatışı öngörmede yüksek duyarlılık ve özgüllüğe sahiptirler.
Anahtar Kelimeler: Çocuk; pnömoni; prognoz
Amaç: Pnömoni, tüm dünyada çocuk ölümlerinin önde gelen sebeplerinden biridir. Çalışmamızda pnömonili çocukların prognozunu tahmin etmede tam kan sayımı [complete blood count (CBC)] parametrelerinin etkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Hastanemizde pnömoni tanısı almış 162 çocuk hasta retrospektif olarak incelendi. Hastalar; yoğun bakımda tedavi görenler (Grup I: ağır şiddette pnömoni, n=57), serviste tedavi görenler (Grup II: orta şiddette pnömoni, n=56) ve ayaktan tedavi ile iyileşenler (Grup III: hafif şiddette pnömoni, n=49) olarak 3 gruba ayrıldı ve hastaların herhangi bir tedavi almadan önce, ilk başvuru anındaki CBC parametreleri karşılaştırıldı. Bulgular: Grup I'deki hastaların eritrosit dağılım genişliği [red cell distribution width (RDW)], nötrofil/lenfosit oranı [neutrophil/lymphocyte ratio (NLR)] ve C-reaktif proteini (CRP) Grup II ve Grup III'teki hastalardan anlamlı şekilde yüksekti, hemoglobin/RDW oranı [hemoglobin/RDW ratio (HRR)] ise anlamlı şekilde düşüktü (p<0,001). Grup I'deki hastalarda RDW ve NLR'nin CRP ile pozitif korelasyon gösterdiği (sırasıyla r=0,637; p<0,001, r=0,705; p<0,001), HRR'nin ise CRP ile negatif korelasyon gösterdiği (r=0,562; p<0,001) saptandı. RDW, NLR, CRP ve bu değerlerin kombinasyonunun şiddetli pnömoni varlığını öngörmede yüksek duyarlılık (sırasıyla %89,5, %91,2, %86,0 ve %87,7) ve özgüllüğe (sırasıyla %86,7, %90,5, %86,7 ve %87,6) sahip oldukları saptandı, eğri altında kalan alanlar değerleri sırasıyla 0,944, 0,945, 0,938 ve 0,953 bulundu. Sonuç: Pnömoni tanısı alan çocuklarda RDW, NLR, HRR ve CRP prognozu tahmin etmede etkili parametrelerdir ve yoğun bakıma yatışı öngörmede yüksek duyarlılık ve özgüllüğe sahiptirler.
Anahtar Kelimeler: Çocuk; pnömoni; prognoz
ABSTRACT
Objective: Pneumonia is one of the leading causes of child death worldwide. In our study, it was aimed to investigate the effect of complete blood count (CBC) parameters in predicting the prognosis of children with pneumonia. Material and Methods: 162 pediatric patients diagnosed with pneumonia in our hospital was reviewed retrospectively. Patients were divided into 3 groups: Those treated in intensive care unit (Group I: severe pneumonia, n=57), those treated in the ward (Group II: moderate pneumonia, n=56) and those who recovered with outpatient treatment (Group III: mild pneumonia, n=49) and the CBC parameters of the patients at the time of first admission were compared before receiving any treatment. Results: Red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) were significantly higher than patients in Group II and Group III, while hemoglobin/RDW ratio (HRR) was significantly lower (p<0.001) in Group I patients. In patients in Group I, RDW and NLR were positively correlated with CRP (r=0.637; p<0.001, r=0.705; p<0.001, respectively), while HRR was negatively correlated with CRP (r=0.562; p<0.001). RDW, NLR, CRP and the combination of these values were found to have high sensitivity (89.5%, 91.2%, 86.0% and 87.7%, respectively) and specificity (86.7%, 90.5%, 86.7% and 87.6%, respectively) in predicting the presence of severe pneumonia, and area under the curve values were 0.944, 0.945, 0.938 and 0.953, respectively. Conclusion: RDW, NLR, HRR and CRP are effective parameters in predicting prognosis in children diagnosed with pneumonia and have high sensitivity and specificity in predicting admission to intensive care unit.
Keywords: Child; pneumonia; prognosis
Objective: Pneumonia is one of the leading causes of child death worldwide. In our study, it was aimed to investigate the effect of complete blood count (CBC) parameters in predicting the prognosis of children with pneumonia. Material and Methods: 162 pediatric patients diagnosed with pneumonia in our hospital was reviewed retrospectively. Patients were divided into 3 groups: Those treated in intensive care unit (Group I: severe pneumonia, n=57), those treated in the ward (Group II: moderate pneumonia, n=56) and those who recovered with outpatient treatment (Group III: mild pneumonia, n=49) and the CBC parameters of the patients at the time of first admission were compared before receiving any treatment. Results: Red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) were significantly higher than patients in Group II and Group III, while hemoglobin/RDW ratio (HRR) was significantly lower (p<0.001) in Group I patients. In patients in Group I, RDW and NLR were positively correlated with CRP (r=0.637; p<0.001, r=0.705; p<0.001, respectively), while HRR was negatively correlated with CRP (r=0.562; p<0.001). RDW, NLR, CRP and the combination of these values were found to have high sensitivity (89.5%, 91.2%, 86.0% and 87.7%, respectively) and specificity (86.7%, 90.5%, 86.7% and 87.6%, respectively) in predicting the presence of severe pneumonia, and area under the curve values were 0.944, 0.945, 0.938 and 0.953, respectively. Conclusion: RDW, NLR, HRR and CRP are effective parameters in predicting prognosis in children diagnosed with pneumonia and have high sensitivity and specificity in predicting admission to intensive care unit.
Keywords: Child; pneumonia; prognosis
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