scholarly journals The Relationships between Neutrophil/Lymphocyte Ratio and Child-Turcotte-Pugh Classification in Assessing Severity of Liver Cirrhosis

2019 ◽  
Vol 3 (1) ◽  
pp. 14-27
Author(s):  
Griselda Griselda ◽  
Kemas Ya'Kub Rahadiyanto ◽  
Rachmat Hidayat
Keyword(s):  
Liver Cirrhosis ◽  
Medical Records ◽  
High Morbidity ◽  
Substantial Agreement ◽  
Age And Gender ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Moderate Agreement ◽  
And Gender ◽  
Kappa Agreement

Background Liver cirrhosis is a disease with high morbidity and mortality in Indonesia. The Child-Turcotte-Pugh classification is a noninvasive parameter to assess severity of liver cirrhosis. Meanwhile, the neutrophil/lymphocyte ratio can reflect person's immunity to liver cirrhosis. This study was conducted to determine the agreement between neutrophil/lymphocyte ratio and Child-Turcotte-Pugh classification in assessing severity of liver cirrhosis. Methods Analytical observational study with Cohen’s Kappa agreement test was conducted in 86 liver cirrhosis patients. Data was retrieved by observing the medical records. Neutrophil count, lymphocyte count, hepatic encephalopathy, ascites, albumin, bilirubin, and INR were all recorded. Documented variables were analyzed by the Cohen’s Kappa agreement test. Results In Cohen’s Kappa agreement test, there was moderate agreement between neutrophil/lymphocyte ratio and Child-Turcotte-Pugh classification in all samples (κ = 0.591 and p <0.001). Agreement between neutrophil/lymphocyte ratio and Child-Turcotte-Pugh classification based on age and gender was found to be κ = 0.777 at age ≤45 years, κ = 0.532 at age >45 years, κ = 0.682 in male, and κ = 0.445 in female (p <0.001). The highest agreement is the substantial agreement between neutrophil/lymphocyte ratio and Child-Turcotte-Pugh classification obtained at age ≤45 years (κ = 0.777 and p <0.001) and male (κ = 0.682 and p <0.001). Conclusion There is moderate agreement between neutrophil/lymphocyte ratio and Child-Turcotte-Pugh classification in assessing severity of liver cirrhosis. Substantial agreement obtained at age ≤45 years and male gender.   Keywords: Neutrophil/Lymphocyte Ratio, Child-Turcotte-Pugh, Liver Cirrhosis

Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

2021 ◽  
pp. 101-104
Keyword(s):  
Complete Blood Count ◽  
Control Group ◽  
Age And Gender ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Inflammatory Parameters ◽  
Group Data ◽  
Healthy Control ◽  
Immature Granulocyte ◽  
And Gender

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

Pattern of calculated inflammation ratios as prognostic values in patients with colorectal cancer

2020 ◽  
Vol 23 ◽  
Author(s):  
Andra Cioca ◽  
Sorana D. Bolboac ◽  
Cristina Druga ◽  
Răzvan A. Cioca ◽  
Florin Grau ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Cirrhosis ◽  
Postoperative Complications ◽  
Ischemic Cardiomyopathy ◽  
Neutrophil To Lymphocyte Ratio ◽  
P Value ◽  
Age And Gender ◽  
Lymphocyte Ratio ◽  
And Gender ◽  
Regional Institute

Aim: In our study, we evaluated the prognostic value of four calculated inflammatory ratios in patients with colorectal cancer. Material and methods: A six years retrospective study was conducted on subjects admitted for colorectal cancer at "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania, from January 2014 until September 2019. The medical charts of patients diagnosed with colorectal cancer were used as the source of raw data and for the calculation of four ratios (neutrophil-to-lymphocyte ratio-NLR, derived neutrophil-to-lymphocyte ratio-dNLR, platelet-to-lymphocyte ratio-PLR, and systemic immune-inflammation index-SII), considered as prognostic markers related to mortality in colorectal cancer. Results: One thousand six hundred and eighty-eight patients, with ages ranging from 17 to 98 years, were evaluated. NLR and dNLR displayed significantly higher values among patients who died (NLR: 4.2 for deceased vs. 3.4 for alive, Pvalue=0.0224; dNLR: 2.7 for deceased vs. 2.3 for alive, P-value=0.0566). Ischemic cardiomyopathy (odds ratio (OR)=2.70), liver cirrhosis (OR=7.84), postoperative complications (OR=2.39), and neutrophil-to-lymphocyte ratio (OR=1.08) proved to be significant prognostic factors for the primary outcome, independent of age and gender. Conclusions: Patients with high NLR, postoperative complications, ischemic cardiomyopathy an d/or liver cirrhosis are the candidates to a less favorable outcome among subjects with colorectal cancer regardless the age and gender.

scholarly journals Profile of Colorectal Tumor in Gastroentero-Hepatology Center, Department of Internal Medicine, Dr Soetomo Hospital, Surabaya

2020 ◽  
Vol 56 (1) ◽  
pp. 15
Author(s):  
Husin Thamrin ◽  
Khafidhotul Ilmiah ◽  
Ni Wajan Tirthaningsih
Keyword(s):  
Colorectal Cancer ◽  
Medical Records ◽  
Colorectal Tumor ◽  
Age And Gender ◽  
Male And Female ◽  
The Third ◽  
Common Cancer ◽  
Significant Difference ◽  
And Gender ◽  
Ethical Clearance

Colorectal cancer has became burden in the world.The latest study shows that colorectal cancer is the third most common cancer in men and second most common cancer in women globally. There are difference characteristic of epidemiology in every countries. Moreover, there is no study that represents epidemiology of colorectal cancer in Indonesia yet, especially in East Java. The aim of this study was to describe colorectal tumor profile by age and gender in Gastroentero-Hepatology Center, Dr Soetomo Hospital. This study has received a certificate of Ethical Clearance No.273/Panke.KKE/IV/2015, a descriptive retrospective study. We collected data using medical records, and patients who have been colonoscopy examination and suspected colorectal tumor were included. There were 201 patients, divided to 100 males and 101 females. The peak of incidence was on 51-60 years old group, but on the 31-40 years old incidence of colorectal tumor was increased. The youngest patient was 17 years old. And tumors are more likely develop in distal area, especially in rectum. This study shows a different characteristic profile of colorectal tumor, where tumor is developed at young people and there is no significant difference between male and female for the incidence.

scholarly journals Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in Missed Abortion

2020 ◽  
Vol 42 (05) ◽  
pp. 235-239
Author(s):  
Ismail Biyik ◽  
Mustafa Albayrak ◽  
Fatih Keskin
Keyword(s):  
Pregnant Women ◽  
Medical Records ◽  
Complete Blood Count ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Missed Abortion ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Inflammatory Parameters

Abstract Objective Missed abortion occurs in ∼ 15% of all clinical pregnancies. The pathogenesis is not clearly known. However, defective placentation resulting in maternal systemic inflammatory response is considered responsible for missed abortion. Platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) are increasingly cited parameters of inflammation in the literature. However, no study evaluated the PLR and NLR rates in missed abortions so far. The aim of the present study is to investigate whether complete blood count (CBC) inflammatory parameters such as NLR and PLR are increased in patients with missed abortion. Methods Medical records of 40 pregnant women whose gestation ended in missed abortion at between 6 and14 weeks of gestation and of 40 healthy pregnant women were collected and compared retrospectively. The groups were compared regarding hemoglobin, hematocrit, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), PLR and NLR. Results Platelet distribution width, NLR and PLR values were higher in the missed abortion group compared with the healthy pregnant women group (rates are p = 0.043; p = 0.038; and p = 0.010, respectively). Hematocrit, MPV, and lymphocyte values were found to be lower in the missed abortion group compared with the healthy pregnant women group (p = 0.027, p = 0.044 and p = 0.025, respectively). Conclusion The PDW, NLR and PLR values of the missed abortion group were reported high; and MPV values were reported low in the present study. These findings may help to speculate a defective placentation in the pathogenesis of missed abortion.

scholarly journals Prediction of prognosis with neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and pathological parameters in operated gastric cancer

2020 ◽  
Vol 7 (11) ◽  
pp. 703-708
Author(s):  
Ozlem Mermut ◽  
Berrin Inanc
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Involvement ◽  
High Morbidity ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Node Involvement

Objective: Inflammatory markers are of prognostic importance in many malignancies. This study aimed to examine the effects of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and pathological parameters on survival in preoperative complete blood counts in patients with operated gastric cancer. Material and Methods: Between 2012 and 2017, 281 patients were analyzed after total/subtotal gastrectomy. According to the ROC curve, we determined the cut-off values for NLR as 2.5 and PLR as 158. Overall survival (OS) was calculated from surgery to the last interview or to death. Results: In univariate analysis age ≥ 55 (p = 0.028), non-adeno hystology (p = 0.003), lenfovascular invasion (LVI) positivity (p = 0.003), perineural invasion (PNI) positivity (p < 0.001), T 3-4 stage (p = 0.006), lymph node involvement (LN) 2-3 (p < 0.001), metastatic stage (p <  0.001), NLR ≥ 2.5 ( p<0.001) and PLR ≥ 158 (p < 0.001) were statistically significant for OS. In multivariate analysis age (HR 0.652, 95% CI: 0.475-0.895; p = 0.008), PNI positivity (HR 0.493, 95% CI: 0.337-0.720; p<0.001), more lymph node involvement (HR: 0.608, 95% CI:0.412-0.896, p = 0.012), metastatic stage (HR 0.377, 95% CI: 0.265-0.537; p < 0.001) and PLR ≥ 158  (HR: 0.610; 95% CI: 0.433-0.859; p = 0.005) were found to be independent prognostic factors affecting OS. Conclusion: Age ≥ 55, PNI positivity, more lymph node involvement, metastatic stage, and PLR ≥ 158  are independent prognostic factors for shorter overall survival. Given the high morbidity and mortality of gastric cancer, besides classical known prognostic factors, parameters such as preoperative PLR may have benefits for forecast the prognosis of gastric cancer.

scholarly journals Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

2021 ◽  
Vol 93 (4) ◽  
pp. 436-440
Author(s):  
Mehmet Demir ◽  
İsmail Yağmur ◽  
Eyyup Sabri Pelit ◽  
Bülent Katı ◽  
Eser Ördek ◽  
...  
Keyword(s):  
Vesicoureteral Reflux ◽  
Lymphocyte Count ◽  
Renal Scarring ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet Volume ◽  
Age And Gender ◽  
Lymphocyte Ratio ◽  
Direct Damage ◽  
And Gender ◽  
The Relationship

Objectives: Vesicoureteral reflux (VUR) exacerbates the risk of renal scarring by establishing a ground for pyelonephritis. It is known that the inflammatory process is more influential than the direct damage caused by bacterial infection in the development of renal scars after pyelonephritis. Therefore, the present study aims to investigate the relationship between renal scarring and systemic inflammatory markers in patients with VUR.Material and methods: Hundred and ninety-two patients (116 females, 76 males) diagnosed with VUR were divided into two groups based on the presence or absence of renal scarring and into three groups according to the grade of VUR (low, moderate and high). Neutrophil count, lymphocyte count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) were compared among the groups.Results: Of the 192 patients, 102 had renal scarring. The age and gender distribution did not differ significantly between the groups with and without renal scarring (p > 0.05). However, the grade of reflux and lymphocyte count were significantly higher in the group with renal scarring (p < 0.05), and the NLR was significantly lower in the group with renal scarring (p < 0.05). The lymphocyte count was significantly higher (p < 0.05) and NLR was significantly lower in the high-grade VUR group (p < 0.05). However, MPV values did not differ significantly (p > 0.05) between the groups. Conclusions: NLR can be used to predict renal scarring in patients with VUR, especially in the period of 3-6 months after the first attack of infection, and may even serve as a candidate marker for treatment selection. However, larger series and prospective studies are needed.

scholarly journals Assessment of platelet-to-lymphocyte ratio in patients with retinal vein occlusion

2020 ◽  
Vol 12 ◽  
pp. 251584142097194
Author(s):  
Bengi Ece Kurtul ◽  
Ayșe İdil Çakmak ◽  
Ahmet Elbeyli ◽  
Deniz Özarslan Özcan ◽  
Sait Coșkun Özcan ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Curve Analysis ◽  
Control Group ◽  
Platelet To Lymphocyte Ratio ◽  
Age And Gender ◽  
Lymphocyte Ratio ◽  
Vein Occlusion ◽  
And Gender ◽  
Receiver Operator Characteristics ◽  
Age And Sex

Purpose: To investigate platelet-to-lymphocyte ratio (PLR) in retinal vein occlusion (RVO) patients. Methods: In this study, we retrospectively reviewed data of 32 patients with RVO (RVO group) and 32 age- and sex-matched participants without RVO (control group) between January 2017 and March 2019. The PLR was determined by dividing the platelet count by the lymphocyte count. Results: Age and gender were comparable between the groups ( p = 0.204 and p = 0.800, respectively). PLR was significantly elevated in the RVO group compared with the control group (137 (113–164) vs 101 (86–129), p = 0.001)). In the receiver operator characteristics curve analysis, the optimal cut-off value of PLR for predicting RVO was 123, with 69% sensitivity and 72% specificity. Conclusion: We report that PLR are elevated in RVO, suggesting that PLR may be a useful marker for RVO.

Abstract MP07: Rising Incidence and Prevalence of Atrial Fibrillation from 2004 to 2013: A Community-Based Study Using Electronic Medical Records

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Brent Williams ◽  
Peter Berger
Keyword(s):  
Health Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Incidence Rates ◽  
Community Based ◽  
Age And Gender ◽  
Annual Increase ◽  
And Gender ◽  
Gender Groups ◽  
Large Health Care System

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia observed in clinical practice and is associated with an elevated risk of stroke and mortality. Evaluating community-level temporal trends in AF incidence and prevalence serve to describe the evolving public health and clinical burden of AF, however recent studies describing AF trends in community-based settings have been inconsistent, with no recent data evaluating trends among individuals under 65 years of age. Accordingly, this study sought to describe community-level trends in AF incidence and prevalence from 2004 to 2013 using the electronic medical records (EMR) of a single, large health care system. Methods: This study includes 329,634 patients receiving primary care and other health care services through the Geisinger Health System (Geisinger) over at least a two-year period. Geisinger consists of over 40 outpatient and seven inpatient facilities spread throughout central and northeastern Pennsylvania. Geisinger’s extensive EMR data repository contains information on demographics, vital signs, social history, diagnoses, medical history, problem lists, medications, procedures, laboratory results, and billing information from all Geisinger encounters since 2001. Incident and prevalent AF were identified by ICD-9 codes observed within any EMR domain. For incident AF, cases had no AF ICD-9 code in the EMR for at least two years prior to the diagnosis. Incidence and prevalence rates were age- and sex-adjusted to the 2010 US census and reported per 1000 person-years (persons). Stratified rates are reported across age groups (<45, 45-54, ¼, >85) and sex. Results: Age- and sex-adjusted AF incidence rates remained relatively stable from 2004 to 2008, but increased sharply thereafter. Incidence rates were 5.0, 5.2, and 8.4 cases per 1000 person-years in 2004, 2008, and 2013, respectively. The overall annual increase was 5.5% per year (95% CI: 4.8, 6.3%). Incidence rates increased significantly in all age and gender groups, with the largest relative increase observed among patients <45 years of age (annual increase in males: 10.8%, females: 11.6%). Prevalence rates increased consistently throughout the entire 10-year period from 23.5 to 39.2 AF cases per 1000 persons from 2004 to 2013 (6.0% annual increase; 95% CI: 5.7, 6.4%). Conclusions: AF incidence and prevalence have been increasing in the community over the last 10 years. Increases were observed in all age and gender groups, with notable increases in the very young. Prevailing trends may be attributable to increased application of AF diagnostics in an aging population and/or an increased clinical recognition of AF due to the recent availability of novel oral anticoagulants for stroke prevention. A mature EMR system functioning within a large health care system can be a powerful tool for performing epidemiologic studies and disease surveillance.

scholarly journals The burden of hip and knee osteoarthritis in Finnish occupational healthcare

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Milla Summanen ◽  
Liisa Ukkola-Vuoti ◽  
Samu Kurki ◽  
Samuli Tuominen ◽  
Rami Madanat
Keyword(s):  
Sick Leave ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Matched Control ◽  
Registry Study ◽  
Control Cohort ◽  
Age And Gender ◽  
Knee Oa ◽  
And Gender ◽  
Occupational Healthcare

Abstract Background Osteoarthritis (OA) is a leading cause of disability and pain especially among older adults, but it is also known to affect working age individuals, often leading to reduced productivity and increased healthcare usage. The aim of this study was to determine the burden of hip and knee OA in Finnish occupational healthcare. Methods This was a retrospective registry study utilizing the electronic medical records of the largest private and occupational healthcare provider in Finland. All consented patients with hip or knee OA were identified. A subcohort of occupational healthcare (OCH) patients was then compared to an age- and gender-matched control group without OA. Patient demographics including comorbidities were determined and healthcare contacts, medication prescriptions, and sick leaves were compared between the two groups. The study period was from January 1st, 2012 to April 30th, 2020. Results 51,068 patients with hip or knee OA were identified (all OA cohort) and 35,109 of these formed the occupational healthcare subcohort. Most of the OA patients were female and belonged to the age group 50–59 years. The point prevalence of hip/knee OA at the end of the study period was 5.6% for the occupational healthcare subcohort. OA patients had 2.2 times more healthcare contacts and 2.8 times more overall sick leave days compared to the age- and gender-matched control cohort. Etoricoxib was the most commonly prescribed medication at OA-related visits (21.8% of patients). Opioids were prescribed to 10.6% of patients at OA-related visits and the most prescribed opioid was a combination of codeine and paracetamol (4.8% of patients). 5054 OA patients (14.4%) had a contraindication for non-steroidal anti-inflammatory drugs (NSAIDs). Conclusions This retrospective registry study utilizing real-world data provides new evidence on the disease burden of hip or knee osteoarthritis from the electronic medical records of Finnish occupational healthcare customers. OA patients had more comorbidities, more healthcare contacts, more sick leave days, and more analgesic prescriptions compared to an age- and gender-matched control cohort without OA.

scholarly journals The neutrophil lymphocyte ratio may predict the discharge status in patients admitted to the emergency department

2020 ◽  
Vol 7 (3) ◽  
pp. 422-425
Author(s):  
Kıvanç Karaman ◽  
Cihangir Çelik ◽  
Esra Fidan ◽  
Alten Oskay
Keyword(s):  
Emergency Department ◽  
Treatment Options ◽  
Female Gender ◽  
Threshold Value ◽  
Additional Time ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Risk Of Mortality ◽  
Discharge Status ◽  
And Gender

Objective: The neutrophil to lymphocyte ratio (NLR) has been investigated as an indicator of mortality and/or morbidity in many clinical pathologies. However, these studies have mostly been conducted for specific diseases. We investigated whether there is a relationship between the NLR and hospitalization or discharge decisions in the emergency department (ED). Methods: We retrospectively reviewed the medical records of patients admitted to the ED. The NLR values of the patients were calculated, and their demographic characteristics (age and gender) and clinical outcomes were recorded. Results: Of the 1970 patients, 1400 (71.1%) were discharged from the ED, and 570 (28.9%) were hospitalized. The patients who were discharged were younger and had lower NLR values, and this group had a lower female gender ratio (p<0.001, p<0.001, and p<0.001, respectively). The NLR threshold for discharge was 4.8, with a sensitivity of 70% and a specificity of 60%. Of the 570 hospitalized patients, 478 (83.9%) were discharged from the hospital and 92 (16.1%) died. Deceased patients were statistically significantly older with higher NLR values (p<0.001 and p=0.001, respectively). The threshold value of NLR for predicting mortality was calculated as 11.5, with a sensitivity of 45% and a specificity of 77%. Conclusions: Our study reveals that the NLR is an important predictor of hospitalization and mortality in patients admitted to the ED regardless of diagnosis. ED physicians may consider to discharge patients with NLR values below 4.8 instead of spending additional time with advanced tests. In addition, clinicians should review the risk of mortality in patients with NLR values greater than 11.5 more thoroughly concerning mortality and should consider early aggressive treatment options.

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