Diagnostic utility of the neutrophil-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study.
BACKGROUND
Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophil-lymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated.


METHODS
A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, as were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain.


RESULTS
Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group (p<0.001), though no difference in NLR was found between the AMI and NVBN groups. In addition, WBC count, CRP level, and NLR were higher in the NVBN group than in the controls (p<0.001).


CONCLUSIONS
We suggest that preoperative NLR aids in the diagnosis of AMI, and can be used to distinguish this condition from NVBN. NLR should be calculated, in addition to clinical examination.
Department of General Surgery, Zonguldak Atatürk State Hospital, Zonguldak-Turkey. drtanrikulu@hotmail.com.
Yusuf
Y
Tanrıkulu
Department of Emergency Medicine, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey.
Ceren
C
Şen Tanrıkulu
Department of General Surgery, Süleyman Demirel University Faculty of Medicine, Isparta-Turkey.
Mehmet Zafer
MZ
Sabuncuoğlu
Department of General Surgery, Erzurum Area Training and Research Hospital, Erzurum-Turkey.
Ayetullah
A
Temiz
Department of Biostatistics, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey.
Furuzan
F
Köktürk
Department of General Surgery, Zonguldak Atatürk State Hospital, Zonguldak-Turkey.
Boran
B
Yalçın
D000368:Aged; D001772:Blood Cell Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000502:physiology*; D008297:Male; D065666:Mesenteric Ischemia / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies