In hospitalized patients in internal medicine, anesthesia and reanimation intensive care units comparison of crp/albumin, neutrophil/lymphocyte and platelet/lymphocyte ratios with apache II score and mortality

Aim: In this study, it was targetted that prospectively evaluation of relationship between CRP/Albumin, Neutrophil/Lymphocyte, Platelet/Lymphocyte ratio, APACHE II score and mortality in 400 patients hospitalized between September 2019 and March 2020 in Department of Internal Medicine and Department of Anestesia and Reanimation Intensive Care Unit. Material and Method: This prospective study has been performed on 400 patients (203 of were male (50.8%), 197 of were male (49.2%)) hospitalized in Ankara City Hospital between September 2019 and March 2020 in Department of Internal Medicine, Department of Anestesia and Reanimation Intensive Care Unit. Older than 18 years patients hospitalized in Department of Internal Medicine and Department of Anestesia and Reanimation Intensive Care Unit were included to our study, patients with trauma, diagnosis of malignity, chronic hepatitis and liver cirrhosis, malnutrition and patients that receiving exogenous albumin therapy were excluded. Biochemical tests that performed in first 24 hours of patients in intensive care unit were CRP, Albumin, absolute Neutrophil count, Lymphocyte and Platelet count. Relationship between these biochemical tests and APACHE II score and 28 days mortality has been examined. Data analyzing was performed with using Statistical Package for Social Sciences (SPSS) for Windows 20 (IBM SPSS Inc., Chicago, IL) Programme. In statistical analysis, p<0.05 (*) value was accepted as significant. Findings: The research population consisted of 400 patients, including 203 women (50.8%) and 197 men (49.2). Age range of patients were 18–103 years and mean value was 73,2±16,1 years. 95.5% (n:382) of research population had accompanying diseaeses. Most common accompanying diseaeses were hypertension (50.5%; n:202), diabetes mellitus (%34,8; n:139), chronic kidney disease (%28,3; n:139), coronary artery disease (%24,5; n:98), chronic heart failure (%24; n:96). Most common hospitalization reason was pneumonia (%29,3). Most common reasons of hospitalization in intensive care unit were pneumonia (%29,3), gastrointestinal bleeding (%10,3), acute attack of chronic kidney disease (%10,3) and acute kidney disease (%7,5) respectively. When the distribution of laboratory findings according to survival in these groups was examined in these groups, mean Neutrophil/Lymphocyte ratio (5,7 vs 11,8; p=0,043) and mean CRP/Albumin ratio (11,1 vs 38; p=0,021) were determined as high significantly in acute attack of chronic kidney disease. Although laboratory findings were found as high, it was not determined statistically significant diversity in pneumonia, gastrointestinal bleeding and acute kidney disease groups. Powerfull positive relationship were determined between APACHE II score and CRP (r=0,840; p<0,001) and CRP/Albumin ratio (r=0,852; p<0,001). Powerfull negative relationship were determined between albumin (r= –0,756; p<0,001) and Prognostic Nutritional Index (r= –0,709; p<0,001) in all of population. Positive correlation with medium strength was determined between Neutrophil/Lymphocyte ratio (r=0,559; p<0,001) and APACHE II score. Positive, week but statistically significant relationship was determined between Platelet/Lymphocyte ratio and APACHE II score. Result: According to our study, statistically significant relationship was determined between APACHE II score and CRP/Albumin ratio, Neutrophil/Lymphocyte ratio, Platelet/Lymphocyte ratio in all of the population. Relationship between mortality and mean Neutrophil/Lymphocyte ratio mean CRP/Albumin ratio was determined in acute attack of chronic kidney disease group. Knowing Neutrophil/Lymphocyte ratio and CRP/Albumin ratio can be an important indicator for estimating mortality ratio and survival in patients that treated in intensive care unit. Key words: Intensive care, CRP/Albumin ratio, Neutrophil/Lymphocyte ratio, Platelet/Lymphocyte ratio, APACHE II, Mortality