Are platelet/lymphocyte ratio and neutrophil/lymphocyte ratio significati̇ve in the acute abdomen?

Background-Target: Acute abdomen; It is a sudden, non-traumatic condition that may require surgical intervention. Since the morbidity and mortality of diseases that cause acute abdominal pain are high, it is important to start the treatment of patients as soon as possible by making an early diagnosis. In our study, neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR), one of the parameters of complete blood count, which is an easily accessible laboratory test, were evaluated. The power of NLR and PLR values in determining discharge service and intensive care admissions in patients presenting with acute abdominal pain, whether they are an effective biomarker in determining the severity of patients, and the mean values of these biomarkers in the diagnosis of radiologically confirmed acute abdominal diseases were investigated. Material-Method: The study was carried out with 200 patients who applied to Celal Bayar University Faculty of Medicine Hafsa Sultan Hospital Emergency Service with complaints of abdominal pain and were diagnosed as "acute abdomen" on 15.01.2020-15.01.2021 and 100 control group were prospectively performed. Results: When looked in the middle of the demographic of those mentioned; The patient group consisted of 113 men (56.5%) and 87 women (43.5%). The control group consisted of 51 men (51%) and 49 women (49%). The mean age of the Patient Group was 51.06, and the control group was 47.47. It was found that the LDH, NLR and PLR values of the patients were higher than the control group and were statistically significant. For the LDH value; It was determined that the ROC analysis gave statistically significant results and the area under the curve was 0.616. When the cut-off value was accepted as> 210, the sensitivity level was 56.5%, specificity was 56%, PKD level was 72%, NKD level was 39.2% and accuracy level was 56.3%. For the NLR value; It was determined that the ROC analysis gave statistically significant results and the area under the curve was 0.904. When the cut-off value was accepted as> 2.877, it was found that the sensitivity level was 85%, the specificity level was 83%, the PKD level was 90.9%, the NKD level was 73.5%, and the accuracy level was 84.3%. For the PLR value; It was determined that the ROC analysis gave statistically significant results and the area under the curve was 0.742. When the cut-off value was accepted as> 129,787, it was determined that the sensitivity level was 69%, the specificity level was 68%, the PKD level was 81.2%, the NKD level was 52.3%, and the accuracy level was 68.7%. According to the outcome diagnosis, there was no statistically significant difference in NLR value, but a statistically significant difference was found in terms of PLR value. A statistically significant positive correlation was found between the LDH, PLR and NLR values of the cases and their WBC values. There was no statistically significant relationship between the LDH, PLR and NLR values of the patients and their fever responses. Conclusion: In our study, the role of laboratory tests in reducing the duration of stay in the emergency services, in decreasing the rates of mortality and morbidity and in determining the severity of abdominal pain complaints in patients presenting to the emergency department with abdominal pain was investigated and it was found that PLR and NLR values gave significant findings to the clinician in showing acute abdomen in patients presenting with complaints of abdominal pain. NLR and PLR values were found to be significant in determining the severity of abdominal pain in patients who applied to the emergency department with abdominal pain. We think that the NLR and PLR measurement value in patients presenting to the emergency department with abdominal pain can be a useful and guiding method for the clinician in identifying critical patients, reducing the number of advanced imaging and predicting the primary outcome.