Van Tıp Dergisi (Oct 2023)
A New Parameter for Predicting Right Ventricular Dysfunction in Pulmonary Embolism: Immature Granulocytes
Abstract
INTRODUCTION: Pulmonary embolism is an urgent health problem and causes high morbidity and mortality when diagnosis is delayed. In addition, detecting the severity of the disease early and starting appropriate treatment prevents complications and mortality due to pulmonary embolism. In recent years, efforts to determine the severity of pulmonary embolism with hemogram parameters that can be easily performed anywhere and anytime, instead of time-consuming and costly examinations, have increased. Right ventricular dysfunction, which indicates the severity of pulmonary embolism, is determined by echocardiography. In this study, we investigated the relationship between inflammatory parameters in the hemogram and immature granulocytes, a new parameter, with right ventricular dysfunction in order to screen for the necessity of echocardiography in pulmonary embolism. METHODS: 57 patients admitted to the university hospital between January 1, 2018 and July 1, 2023 and diagnosed with pulmonary embolism by computed tomography pulmonary angiography were included in the study. Demographic, echocardiographic, radiological and laboratory data of the cases were obtained from hospital records and the results were analyzed retrospectively RESULTS: Of the 57 patients included in the study, 36 (63.2%) were male and 21 (36.8%) were female. There were 18 (31.6%) patients with right ventricular dysfunction and 39 (68.4%) patients without. Mean age was 52.39+-15.56. A significant correlation was found between right ventricular dysfunction and immature granulocyte count (p<0.05). In multivariate logistic regression analysis, immature granulocyte value was found to be a significant and independent variable in predicting right ventricular dysfunction (p˂ 0.05). DISCUSSION AND CONCLUSION: As a result, the relationship between immature granulocytes measured in complete blood count and pulmonary embolism was examined. For the first time, the increase in immature granulocytes was found to be a significant and independent variable in predicting right ventricular dysfunction in pulmonary embolism. We believe that this result may have prognostic value for estimating the severity of pulmonary embolism and the need to screen for right ventricular dysfunction.
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