Investigation of the relationship of neutrophil lymphocyte rate and pro-bnp values and pulmonary emboly in patients with pulmonary CT angio imaging with the prediagnose of pulmonary emboly in the emergency department

Aim: Pulmonary embolism (PE) covers a wide range of presentations, from an asymptomatic individual to a life-threatening medical emergency. Pulmonary embolism requires prompt diagnosis and treatment as it is a major cause of death world wide with over 100,000 deaths in 2018. In this study, the status of patients with pulmonary embolism diagnosis and neutrophil lymphocyte ratio, as well as the relationship between patients' d-dimer values and neutrophil lymphocyte ratio were evaluated. Method:Patients who under went pulmonary CT angiography with a preliminary diagnosis of pulmonary embolism in the Emergency Department between 30.04.2019 and 30.04.2021 were screened retrospectively. Statistical analysis of the data was made in IBM SPSS Statics Version 26 program. Pearson Chi-Square and Fisher's Exact test were used to compare categorical data between groups, and Mann Whitney U statistical analyzes were used to compare continuous data between two groups, since continuous data did not have a normal distribution feature. The predictive power of age and laboratory values for presence of embolism and exitus was evaluated by ROC analysis. While evaluating the data, p˂0.05 was considered statistically significant. Findings: Of the subjects included in the study, 60.1% were men and 39.9% were women. In the study, the median age of men was found to be statistically lower than the median age of women. Pulmonary CT angiography imaging of the cases revealed pulmonary embolism in 16% (n=83). In our study, when examined as the type of embolism, segmental embolism (14.9%) was found the most. As a result of the ROC analysis performed to determine the power of laboratory data to predict the presence of PE; D-dimer, CRP and Troponin were found to be statistically significant. When the NLR cut-off value is 3.68, it's sensitivity is 90.91% (95% CI 70.84% - 98.88%), specificity is 38.67% (95% CI 27.64% - 50.62%), and the AUC value was 0.670 (95% CI 0.548-0.792). Conclusion:In our study, there was no statistically significant difference between the groups in terms of NLR value according to the presence of embolism. However, when the distribution of laboratory values for exitus status was examined, the NLR value was found to be significant. NLR has been found to be a readily available indicator for short-term mortality.