title: Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism.
abstract: BACKGROUND
  The aim of this study was to determine the hematologic parameter with the highest diagnostic differentiation in the identification of massive acute pulmonary embolism (APE).
  
  
  METHODS
  A retrospective study was performed on patients diagnosing with APE between June 2014 and June 2016. All radiological and laboratory parameters of patients were scanned through the electronic information management system of the hospital. PLR was obtained from the ratio of platelet count to lymphocyte count, NLR was obtained from the ratio of neutrophil count to lymphocyte count, WMR was obtained from white blood cell in mean platelet volume ratio, MPR was obtained from the ratio of mean platelet volume to platelet count, and RPR was obtained from the ratio of red distribution width to platelet count.
  
  
  RESULTS
  Six hundred and thirty-nine patients consisting of 292 males (45.7%) and 347 females (54.3%) were included in the research. Independent predictors of massive risk as compared to sub-massive group were; pulmonary arterial systolic pressure (PASP) (OR=1.40; P=.001), PLR (OR=1.59; P<.001), NLR (OR=2.22; P<.001), WMR (OR=1.22; P<.001), MPR (OR=0.33; P<.001), and RPR (OR=0.68; P<.001). Upon evaluation of the diagnostic differentiation of these risk factors for massive APE by employing receiver operating characteristic curve analysis, it was determined that PLR (AUC±SE=0.877±0.015; P<.001), and NLR (AUC±SE=0.893±0.013; P<.001) have similar diagnostic differentiation in diagnosing massive APE and these two parameters are superior over PASP, MPR, WMR, and RPR.
  
  
  CONCLUSIONS
  We determined that the levels of NLR and PLR are superior to other parameters in the determination of clinical severity in APE cases.
authors.affiliation: Department of Chest Disease, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Hale
authors.initials: H
authors.lastname: Ates
authors.affiliation: Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ates
authors.affiliation: Department of Cardiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Kundi
authors.affiliation: Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatma Meric
authors.initials: FM
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count / Q000706:statistics & numerical data*; D001792:Blood Platelets / Q000166:cytology; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D011655:Pulmonary Embolism / Q000097:blood* / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
keywords: acute pulmonary embolism; massive embolism; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio