PLATELET TO LYMPHOCYTE RATIO (PLR) AND NEUTROPHIL TO LYMPHOCYTE RATIO (NLR) – PREDICTOR OF MORTALITY IN PEPTIC ULCER PERFORATION PATIENTS
Peptic ulcer perforation (PUP) and peritonitis is a high-risk acute abdomen event that constitutes 5% of all abdominal emergencies. Despite the best surgical treatment, there is high rates of morbidity and mortality. Multiple factors and scoring systems are in system to identify patients at high risk of mortality 1-3. Still the clinicians and intensivist are motivated to search for new laboratory markers that is simple, routinely available and is cost effective to predict morbidity and mortality in preop and post op settings4-5. This study aimed to evaluate and establish the role of two such markers - PLR and NLR.
Methods: This study is an observational prospective study which was conducted in the Department of Surgery, NSCB Medical college Jabalpur from December 2018 to September 2020. Data of 400 patients with PUP collected at time of admission and were managed surgically for Peptic Ulcer Perforation. Patient were followed for outcomes post-surgery. The PLR, NLR was calculated for each Patient. The predictive power of these values and their differences were studied using the area under the receiver-operator characteristic (ROC) curve and regression analysis.
Result: The analysis was made by comparing the values of PLR and NLR in different groups of patients i.e., between Gender, Age and Duration of hospital stay. ROC curve analysis found that the value of PLR ≥ 216.1 and NLR ≥ 10.68 could have diagnostic value in predicting the mortality in Peptic Ulcer Perforation patients.
Conclusion: In this study, it was concluded that there is a significant correlation of PLR and NLR to mortality of patients following management of PUP and hence can be used as an effective independent single variable for this.
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