The relationship between prognosis and mortality of mean platelet volume (MPV),neutrophil lymphocyte rate (NLR) and platelet to lympocyte ratio(PLR) values in patients with pediatric multitravma in emergency service

One of the most important causes of morbidity and mortality in the world is pediatric traumas. Trauma is the most common cause of mortality in children older than 1 year. Children with multiple traumatic injuries can be difficult to treat and important injuries may not be easily diagnosed. Early diagnosis of severe injuries, initiation of appropriate diagnostic studies and rapid stabilization of injuries play a key role in reducing morbidity and mortality in pediatric trauma patients. Differential diagnoses for these patients are numerous and treatment has been determined according to certain injuries. In order to evaluate pediatric trauma correctly, an algorithm must be followed. At the end of this algorithm, a scoring system that specifies the condition of the trauma patient should be used. Hemodynamic stability, level of consciousness, and injury severity score (ISS) are predictors of survival after traumatic injury. MPV is associated with platelet activation, and in the case of inflammation the blood level changes. Platelets are vital components of normal hemostasis and can secrete many inflammatory cytokines. MPV increases in low-grade inflammation and decreases in more severe inflammation due to intense platelet consumption in inflammatory sites. MPV is a reflection of proinflammatory situations which inflammatory cytokines regulate the inflammatory process. Physiological response of circulating leukocytes to stress; an increase in neutrophil count and decrease in lymphocyte count. Therefore, the ratio of these two subgroups to each other (NLR) is used as an indicator of inflammation. PLO is another indicator of systemic inflammatory response seen in complete blood count. Platelet count may increase under inflammatory conditions and bleeding, which may lead to an increase in expression of inflammatory cytokines and thrombocytosis. Elevated platelet counts may reflect underlying inflammation and low lymphocyte counts may represent uncontrolled inflammatory signaling. Therefore, elevated PLR may be a useful marker of systemic inflammation. PLR has been reported to be associated with disease severity, survival, differential diagnosis, prognosis and follow-up in various studies of various diseases. In this study, patients who were admitted to the Emergency Department of ₂₂to multitrauma were evaluated retrospectively. Admission characteristics, clinical features, examinations (laboratory tests, imaging results), consultations and results, hospitalization and mortality were reviewed retrospectively. Firstly, the hospital automation system was scanned retrospectivly and the names of the patients who applied for multitravma were found. Using these names and id numbers, emergency department patient examination cards were removed from the archive and patients who meet the predetermined criteria were included in the study. Age, gender, type of trauma, date of admission, referral vitals (body temperature, systolic and diastolic blood pressure values, heart rate and O2 saturation) of the patient were researched from examination cards. Laboratory test results of patients (WBC, platelet, MPV, lymphocyte, etc.) Intensive care unit hospitalization situation, postoperative hospital length of stay, mechanical ventilator requirement and mortality were examined and recorded for each patient. A total of 724 patients were included in the study over a 24-month period. In our study patients under age 15, patients whose results and information were unreachable, patients diagnosed idiopathic thromcytopenic purpura, thrombotic thrombocytopenic purpura and essential thrombocytosis were excluded. The study was completed with 597 patients who meet the criteria. Age, sex, type of trauma, referrance season and laboratory results, number of hospitalization days and mortality were evaluated. In this study, we wanted to investigate the place of NLR, PLR and MPV values in the life-threatening multitrauma patients at the time of admission in predicting mortality and prognosis according to injury severity score (ISS).