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Predictive Value of Neutrophil Lymphocyte Ratio and Wells Score in Patients with Pulmonary Embolism after Trauma

DOI: 
10.7727/wimj.2015.483

ABSTRACT

Objective: Trauma patients have a high risk of deep vein thrombosis and pulmonary embolism. There are very few studies that apply Wells scoring, which is the most commonly used instrument for the early diagnosis of the trauma patients who are at risk of and suspected of suffering from pulmonary embolism. In recent years, the neutrophil lymphocytes ratio in peripheral blood has been suggested to be used in pulmonary embolism diagnosis as a good marker of inflammation. This study aims to investigate the efficiency of NLR and the Wells score for predicting pulmonary embolism in patients who are admitted to the emergency department due to trauma.

Methods: In this study, 7,321 trauma patients were retrospectively examined. Following the trauma, 76 patients who were admitted to the computed tomographic pulmonary angiography (CTPA) was taken in order to evaluate the potential existence of pulmonary embolism within one month after the first trauma during their acute hospitalization or they represented to the emergency department for symptoms. Patients were divided into two groups (i.e., a pulmonary embolism group and a non-pulmonary emboli group), according to the tomography results and after the NLR and Wells scoring were calculated and compared according to the patients’ clinical findings at the time of application.

Results: In this study, 36 people were in the pulmonary embolism group and 40 people were in the non-pulmonary embolism group. In the analysis of the receiver operator characteristics when the cut-off value was 3.2 for NLR, pulmonary embolism was detected with 94.4% sensitivity and 87.5%specificity. When the cut-off is 4 for the Wells score, pulmonary embolism was detected with 83.3% sensitivity and 100% specificity.

Conclusion: NLR and Wells scoring may be used to predict acute pulmonary embolism in trauma patients.

Accepted: 
25 Nov, 2015
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e-Published: 14 Mar, 2016

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