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Do Hemogram Parameters Correlate With The Level and Location of The Obstruction In Acute Mesenteric Ischemia Patients?

Year 2019, Issue: 3, 542 - 546, 01.09.2019

Abstract

Background and Objectives: Acute mesenteric ischemia AMI is a disease with high mortality that needs early diagnosis and management. There has been a recent trend in the search for a fast prognostic tool for AMI. Hemogram parameters are widely used tools in emergency departments since they are inexpensive and fast.In this study our primary objective was to evaluate the significance of hemogram parameters in predicting the level of obstruction in superior mesenteric artery SMA and truncus coeliacus TC . Our secondary objective was to evaluate the significance of hemogram parameters in predicting the location of obstruction in AMI patients.Methods: In this retrospective study, we reviewed medical records of 214 AMI patients including; hemoglobin, hematocrit, platelet, mean platelet volume, red blood cell distribution width counts and computed tomography scan results. Patients with missing data were excluded and 208 patients were enrolled. Results: Among 208 AMI patients, 123 59.1% were male. The median age was 68 IQR: 59, 77 . There were no significant differences between the obstruction level groups for the hemogram parameters neither in SMA nor in TC. The difference between obstruction location groups for hemogram parameters were clinically insignificant.Conclusion: We found that hemogram parameters do not correlate with the level and location of the obstruction in AMI patients. Other pathophysiological processes seem to be more important for the survival of those patients

References

  • 1. van den Heijkant TC, Aerts BA, Teijink JA, Buurman WA, Luyer MD. Challenges in diagnosing mesenteric ischemia. World J Gastroenterol 2013; 19: 1338-41.
  • 2. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta‐analysis. Academic Emergency Medicine 2013;20:1087-100.
  • 3. Kassahun WT, Schulz T, Richter O, Hauss J. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbeck’s archives of surgery 2008; 393: 163-71.
  • 4. Aktekin A, Emir S, Saglam A. [Factors affecting mortality in acute mesenteric obstruction]. Ulus Travma Acil Cerrahi Derg 2009;15:217-21.
  • 5. Unalp HR, Atahan K, Kamer E, Yasa H, Tarcan E, Onal MA. [Prognostic factors for hospital mortality in patients with acute mesenteric ischemia who undergo intestinal resection due to necrosis]. Ulus Travma Acil Cerrahi Derg 2010; 16: 63-70.
  • 6. Bilgic IC, Gelecek S, Ozmen MM, Kasapoglu B. The association of elevated mean platelet volume with the outcome of acute mesenteric ischemia. Blood Coagul Fibrinolysis 2015; 26: 727-30.
  • 7. Altintoprak F, Arslan Y, Yalkin O, Uzunoglu Y, Ozkan OV. Mean platelet volume as a potential prognostic marker in patients with acute mesenteric ischemia-retrospective study. World J Emerg Surg 2013;8: 49.
  • 8. Degerli V, Ergin I, Duran FY, Ustuner MA, Duran O. Could Mean Platelet Volume Be a Reliable Indicator for Acute Mesenteric Ischemia Diagnosis? A Case-Control Study. Biomed Res Int 2016;2016: 9810280.
  • 9. Kisaoglu A, Bayramoglu A, Ozogul B, Atac K, Emet M, Atamanalp SS. Sensitivity and specificity of red cell distribution width in diagnosing acute mesenteric ischemia in patients with abdominal pain. World J Surg 2014; 38: 2770-6.
  • 10. Dinc T, Yildiz BD, Kayilioglu I, Sozen I, Cete M, Coskun F. Red cell distribution width, gamma glutamyl transpeptidase and anticoagulant use affect mortality in acute arterial mesenteric ischemia. Perfusion 2015; 30: 337-40.
  • 11. Bilgic I, Dolu F, Senol K, Tez M. Prognostic significance of red cell distribution width in acute mesenteric ischemia. Perfusion 2015;30:161-5.
  • 12. Turkoglu A, Gul M, Oguz A, Bozdag Z, Ulger BV, Yilmaz A, et al. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg 2015; 100: 962-5.
  • 13. Wang Z, Chen JQ, Liu JL, Tian L. A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward. World J Surg 2017.
  • 14. Walker TG. Mesenteric vasculature and collateral pathways. Semin Intervent Radiol 2009; 26: 167-74.
  • 15. Martinez JP, Hogan GJ. Mesenteric ischemia. Emergency medicine clinics of North America 2004; 22: 909-28.

Akut Mezenter İskemi Hastalarında Hemogram Parametreleri Tıkanıklığın Düzeyi ve Yeri İle İlişkili midir ?

Year 2019, Issue: 3, 542 - 546, 01.09.2019

Abstract

Amaç: Akut mesenterik iskemi AMİ , erken teşhis ve tedaviye ihtiyaç duyan yüksek mortaliteye sahip bir hastalıktır. AMİ için hızlı bir prognostik araç araştırılmaktadır. Hemogram parametreleri ise; ucuz ve hızlı olduklarından, acil servislerde yaygın olarak kullanılan tanısal araçlardır.Bu çalışmadaki birincil amacımız, superior mezenterik arter SMA ve trunkus çöliyakustaki TÇ obstrüksiyon düzeylerinin öngörülmesinde, hemogram parametrelerinin öneminin değerlendirilmesidir. İkincil amacımız ise AMİ hastalarında obstrüksiyonun yerinin belirlenmesinde hemogram parametrelerinin öneminin değerlendirilmesidir.yöntemler: Bu retrospektif çalışmada, 214 AMİ hastasının tıbbi kayıtları incelenerek; hemoglobin, hematokrit, trombosit, MPV, RDW değerleri ve bilgisayarlı tomografi sonuçları kaydedilmiştir. Kayıtlarında eksikleri olan hastalar dışlanmıştır ve 208 hasta çalışmaya dahil edilmiştir.Bulgular: 208 AMİ hastasının 123’ü % 59.1 erkekti. Medyan yaş 68 idi IQR: 59, 77 . SMA’da ve TÇ’da obstrüksiyon düzeyi grupları arasında, hemogram parametreleri açısından anlamlı bir farklılık saptanmadı. Obstrüksiyon lokasyon grupları arasındaki fark da hemogram parametreleri açısından klinik olarak anlamlı değildi.Sonuç: AMİ hastalarında, hemogram parametrelerinin, obstrüksiyonun düzeyi ve lokasyonu ile ilişkili olmadığını tespit ettik. Diğer patofizyolojik süreçler, bu hastaların hayatta kalması için daha önemli gibi görünmektedir

References

  • 1. van den Heijkant TC, Aerts BA, Teijink JA, Buurman WA, Luyer MD. Challenges in diagnosing mesenteric ischemia. World J Gastroenterol 2013; 19: 1338-41.
  • 2. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta‐analysis. Academic Emergency Medicine 2013;20:1087-100.
  • 3. Kassahun WT, Schulz T, Richter O, Hauss J. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbeck’s archives of surgery 2008; 393: 163-71.
  • 4. Aktekin A, Emir S, Saglam A. [Factors affecting mortality in acute mesenteric obstruction]. Ulus Travma Acil Cerrahi Derg 2009;15:217-21.
  • 5. Unalp HR, Atahan K, Kamer E, Yasa H, Tarcan E, Onal MA. [Prognostic factors for hospital mortality in patients with acute mesenteric ischemia who undergo intestinal resection due to necrosis]. Ulus Travma Acil Cerrahi Derg 2010; 16: 63-70.
  • 6. Bilgic IC, Gelecek S, Ozmen MM, Kasapoglu B. The association of elevated mean platelet volume with the outcome of acute mesenteric ischemia. Blood Coagul Fibrinolysis 2015; 26: 727-30.
  • 7. Altintoprak F, Arslan Y, Yalkin O, Uzunoglu Y, Ozkan OV. Mean platelet volume as a potential prognostic marker in patients with acute mesenteric ischemia-retrospective study. World J Emerg Surg 2013;8: 49.
  • 8. Degerli V, Ergin I, Duran FY, Ustuner MA, Duran O. Could Mean Platelet Volume Be a Reliable Indicator for Acute Mesenteric Ischemia Diagnosis? A Case-Control Study. Biomed Res Int 2016;2016: 9810280.
  • 9. Kisaoglu A, Bayramoglu A, Ozogul B, Atac K, Emet M, Atamanalp SS. Sensitivity and specificity of red cell distribution width in diagnosing acute mesenteric ischemia in patients with abdominal pain. World J Surg 2014; 38: 2770-6.
  • 10. Dinc T, Yildiz BD, Kayilioglu I, Sozen I, Cete M, Coskun F. Red cell distribution width, gamma glutamyl transpeptidase and anticoagulant use affect mortality in acute arterial mesenteric ischemia. Perfusion 2015; 30: 337-40.
  • 11. Bilgic I, Dolu F, Senol K, Tez M. Prognostic significance of red cell distribution width in acute mesenteric ischemia. Perfusion 2015;30:161-5.
  • 12. Turkoglu A, Gul M, Oguz A, Bozdag Z, Ulger BV, Yilmaz A, et al. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg 2015; 100: 962-5.
  • 13. Wang Z, Chen JQ, Liu JL, Tian L. A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward. World J Surg 2017.
  • 14. Walker TG. Mesenteric vasculature and collateral pathways. Semin Intervent Radiol 2009; 26: 167-74.
  • 15. Martinez JP, Hogan GJ. Mesenteric ischemia. Emergency medicine clinics of North America 2004; 22: 909-28.
There are 15 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Erkman Sanrı

Sinan Karacabey

Haldun Akoglu

Publication Date September 1, 2019
Published in Issue Year 2019Issue: 3

Cite

EndNote Sanrı E, Karacabey S, Akoglu H (September 1, 2019) Do Hemogram Parameters Correlate With The Level and Location of The Obstruction In Acute Mesenteric Ischemia Patients?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 3 542–546.