Can the leukocyte`s parameters in peripheral blood smear predict the risk of in-hospital death of patients undergoing high-risk gastrointestinal surgery?
Journal Title: Polish Journal of Surgery - Year 2019, Vol 91, Issue 1
Abstract
Introduction. White blood cell (WBC) count constitutes a part of routine peripheral blood examination (FBC, full blood count). Precise analysis of leukocytes’ parameters in blood smear is usually performed only when leukopenia or leukocytosis is found. We aimed to assess the usefulness of leukocytes’ smear test in predicting in-hospital death of patients undergoing high-risk gastrointestinal (GI) surgery. Materials & Methods. We prospectively enrolled 101 subjects undergoing high-risk GI surgery from 01.01.2017 till 31.12.2017. Blood tests were performed preoperatively, with analysis focused on the assessment of total WBC count, as well as the count of neutrophils (NEUT), lymphocytes (LYM), monocytes (MONO), eosinophils (EOS) and basophils (BASO). Indices of NEUT/LYM (NLR) and MONO/LYM (MLR) were calculated. In-hospital mortality was considered the outcome. Results. Mortality reached 5%. There was no significant difference in WBC count between survivors and the deceased (p=0.2) and WBC failed to predict the outcome (AUC=0.69; p=0.3). MONO (p=0.009) and BASO (p=0.02) counts, as well as MLR (p=0.007) were significantly higher in patients who died. MONO count and MLR index predicted in-hospital death with good accuracy, respectively: AUC[MONO]=0.85 (p<0.001) and AUC[MLR]=0.86 (p<0.001). Other investigated parameters played no significant role in outcome prediction. Conclusion. Routine peripheral blood smear evaluation should be considered in all patients undergoing high-risk GI surgery, because the number of monocytes can be a valuable predictor of in-hospital death. <br/><br/>
Authors and Affiliations
Michał Pluta, Łukasz Krzych
Keywords
Related Articles
- EP ID EP420594
- DOI 10.5604/01.3001.0012.7792
- Views 116
- Downloads 0
Does abdominal ultrasound is a useful tool in appendicitis diagnosis?
Introduction: Acute appendicitis is the most common acute abdominal illness. Despite diagnosis progress there is still 20% negative appendectomy rate. The aim of the study was to determine the usefulness of abdominal son...
Ciśnieniowe pęknięcie przełyku (zespół Boerhaavego) jako diagnostyczne i terapeutyczne wyzwanie wymagające szybkiej i skutecznej współpracy międzyklinicznej. Raport przypadku z regionalnego ośrodka specjalizującego się w chorobach przełyku
Prezentujemy opis przypadku 47-letniego mężczyzny przyjętego do naszego ośrodka z powiatowego Szpitalnego Oddziału Ratunkowego z objawami wstrząsu septycznego i podejrzeniem zespołu Boerhaavego. Po potwierdzeniu rozpozna...
The Role of Apolipoprotein (A) In Pathogenesis and Clinical Course of Deep Venous Thrombosis
Deep venous thrombosis is widespread disease, which complications, like: pulmonary embolism and postphlebitis syndrome areimportant social problem. There are many well-known and accurately described risk factors, though...
Surgical treatment of acute appendicitis in older patients
Introduction: Acute appendicitis (AA) is the most common indication for emergency surgery and it occurs more often in children and young adults than in patients of advanced age. AA in older patients is a challenging surg...
The Strategies of Coping with Stress in Workplace Used by Surgeons Working in Different Hospitals - A Pilotage Research