| Autor: |
Serban D; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania., Stoica PL; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania., Dascalu AM; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania., Bratu DG; Faculty of Medicine, University Lucian Blaga Sibiu, 550169 Sibiu, Romania.; Department of Surgery, Emergency County Hospital Sibiu, 550245 Sibiu, Romania., Cristea BM; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania., Alius C; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania., Motofei I; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Department of General Surgery, Emergency Clinic Hospital 'Sf. Pantelimon' Bucharest, 021659 Bucharest, Romania., Tudor C; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania., Tribus LC; Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Department of Internal Medicine, Ilfov Emergency Clinic Hospital Bucharest, 022104 Bucharest, Romania., Serboiu C; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania., Tudosie MS; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania., Tanasescu D; Department of Nursing and Dentistry, Faculty of General Medicine, University Lucian Blaga Sibiu, 550169 Sibiu, Romania., Vancea G; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Clinical Hospital of Infectious and Tropical Diseases 'Dr. Victor Babes', 030303 Bucharest, Romania., Costea DO; Faculty of Medicine, Ovidius University Constanta, 900470 Constanta, Romania.; General Surgery Department, Emergency County Hospital Constanta, 900591 Constanta, Romania. |
| Abstrakt: |
The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) to predict advanced inflammation, the risk for conversion, and postoperative complications in AC. Advanced AC was considered the cases with empyema, gangrene, perforation of the gallbladder, abscesses, or difficulties in achieving the critical view of safety. A 3-year retrospective was performed on 235 patients admitted in emergency care for AC. The NLR was superior to the PLR and SII in predicting advanced inflammation and risk for conversion. The best predictive value was found to be at an NLR "cut-off" value of >4.19, with a sensitivity of 85.5% and a specificity of 66.9% (AUC = 0.824). The NLR, SII, and TG 13/18 correlate well with postoperative complications of Clavien-Dindo grade IV ( p < 0.001 for all variables) and sepsis. For predicting early postoperative sepsis, TG 13/18 grading >2 and NLR > 8.54 show the best predicting power (AUC = 0.931; AUC = 0.888, respectively), although not significantly higher than that of the PLR and SII. The NLR is a useful biomarker in assessing the severity of inflammation in AC. The SII and PLR may be useful in the prediction of systemic inflammatory response. |
