背景:憩室炎是一种常见的胃肠道疾病,可能需要手术干预。该研究的目的是调查中性粒细胞-淋巴细胞比率(NLR)和血小板-淋巴细胞比率(PLR)作为墨西哥患者复杂性憩室病(CDD)严重程度的生物标志物,以及它们与需要手术干预的相关性。住院时间,和死亡率。
方法:观察性,纵向,2017年至2021年进行的回顾性研究考虑了18岁以上的患者,通过使用计算机断层扫描进行CDD诊断,并在进入急诊科后的前24小时内进行血液造影以描述敏感性,特异性,以及阳性和阴性预测值(PPV和NPV,分别)CDD中的NLR和PLR。结果:共有102名墨西哥患者患有CDD,54%的女性和46%的男性,平均59岁,进行了分析。根据欣奇的分类,79例(77.5%)患者表现为I型,12(12.8%)II型,5(4.9%)III型,和6(5.9%)IV型。平均住院时间为8.8天,死亡率为3.9%。根据受试者工作特征(ROC)曲线的结果,NLR的临界值为5.1,曲线下面积(AUC)为0.633,灵敏度为90%,特异性为43%,PPV为21.8%,预测CDD的NPV为96%。根据ROC曲线的结果,在72时建立PLR的截断值,AUC为0.482,灵敏度为78%,特异性为40%,PPV为96%,净现值为9%,用于预测CDD。
结论:NLR和PLR是易于计算和获取的生物标志物,可以作为墨西哥人群CDD诊断和治疗决策的一部分,正如在其他人群中观察到的那样。然而,更有前瞻性,需要多中心比较研究来评估这些生物标志物与已经描述的生物标志物的有效性和安全性。
BACKGROUND: Diverticulitis is a prevalent gastrointestinal disease that may require surgical intervention. The aim of the study was to investigate the involvement of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as biomarkers of severity in complicated diverticular disease (CDD) in Mexican patients and their correlation with the need for surgical intervention, the length of hospital stay, and mortality.
METHODS: An observational, longitudinal, and retrospective study performed from 2017 to 2021 was considered in patients over 18 years of age, with a diagnosis of CDD by using computed tomography and with a hemogram taken in the first 24 hours upon admission to the emergency department to describe the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of NLR and PLR in the CDD. Results: A total of 102 Mexican patients suffering from CDD, 54% women and 46% men with a mean of 59 years, were analyzed. According to Hinchey\'s classification, 79 (77.5%) patients showed type I, 12 (12.8%) type II, 5 (4.9%) type III, and 6 (5.9%) type IV. The mean hospital stay was 8.8 days, with a mortality rate of 3.9%. The cut-off value was established at 5.1 for NLR according to the results of the receiver operating characteristic (ROC) curve with an area under the curve (AUC) of 0.633, a sensitivity of 90%, a specificity of 43%, PPV of 21.8%, and NPV of 96% for the prediction of CDD. A cut-off value for PLR at 72 was established according to the results of the ROC curve with an AUC of 0.482, a sensitivity of 78%, a specificity of 40%, PPV of 96%, and NPV of 9% for the prediction of CDD.
CONCLUSIONS: The NLR and PLR are easily calculable and accessible biomarkers that can be part of the decision-making for the diagnosis and treatment of CDD in Mexican people as has been observed in other populations. However, more prospective, multicenter comparative studies are needed to assess the efficacy and safety of these biomarkers in relation to those already described.