In this study, we aimed to evaluate the mean platelet voulme (MPV) levels of trauma patients who were admitted to our emergency department. Of the total 232 trauma patients, 40 females and 192 males over the age of 18 years were included in this study. Of them, 102 patients were mild trauma [Glasgow Coma Scale (GCS) 15-13)], 40 patients were moderate (GCS 12-9) and 90 patients were severe trauma (GCS 8-3) patients. We also calculated the Revised Trauma Score (RTS) of the patients. MPV levels were evaluated with GCS and RTS values. The control group was constituted of 100 healthy adults. Mean initial MPV value of GCS 15-13 patients was 8.25 fL, 8.25 fL in GCS 12-9 patients and 8.47 fL, in GCS 8-3 patients. Trauma severity was significantly related with initial MPV (iMPV) levels (p<0.05), initial Hb (iHb) levels (p<0.05), initial white blood count (iWBC) (p<0.05) and initial platelet (iPlt) levels (p<0.05). Severity of trauma was related with control MPV (kMPV) levels (p<0.05), control Hb (kHb) (p<0.05), control WBC (kWBC) (p<0.05), control Plt (kPlt) levels (p<0.05). MPV levels (p<0.05), Hb levels (p<0.05), WBC levels (p<0.05), Plt levels (p<0.05) were significantly different between trauma group and healthy group. IMPV and control kMPV levels were not related (p=0.149). But kHb - iHb levels (p<0.05), kWBC - iWBC levels (p<0.05), kPlt - iPlt levels (p<0.05), kGCS - iiGCS (p<0.05) were related to each other. We found a correlation between iMPV and iWBC levels (p<0.05, r=-0.342). Similarly, there was a correlation between severity of trauma and iMPV level (p<0.05, r=-0.224). We determined a significant correlation between iMPV and iPlt levels (p<0.05, r=-0.246). There was not a correlation between kMPV and kWBC (p>0.05, r=0.124). kMPV and kPlt levels (p<0.05, r=-0.174) were correlated. RTS was statistically related with GCS (p<0.05). Similarly, RTS was related with iMPV (p<0.05), iWBC(p<0.05) and iPlt (p<0.05) values, but there was not a relation with iHb (p>0.05). We found correlations between iMPV- trauma severity (p<0.05, r=-0.224), iMPV - RTS (p<0.05, r=0.134), iMPV - iWBC (p<0.05 r=-0.342), iMPV - iPlt (p<0.05, r=-0.246). Control RTS (seventh day of hospitalization) values were not related to kMPV (p>0.05), kHB (p>0.05), kWBC (p>0.05) and kPlt(p>0.05). There was a correlation between kRTS and kMPV (p<0.05, r=-0.169). Similarly, kMPV - kHb (p<0.05, r=-0.141), kMPV - kPlt (p<0.05, r=-0.174) were correlated. KMPV and kPlt were not correlated (p<0.05, r=0.124). Initial RTS and seventh day RTS values were significantly different (p<0.05). MPV may be helpful for emergency physicians for predicting the severity of trauma.
AmaçAcil Servise (AS) başvuran TİA (Geçici iskemik atak) tanısı almış hastaların plazma kopeptin düzeylerini sağlıklı kontrollerle karşılaştırarak TİA saptamak için kopeptin'in tanısal doğruluğunu araştırmayı amaçladık. Gereç ve YöntemAcil servise nörolojik bir semptomla başvuran hastalar arasında ileriye dönük bir vaka kontrol çalışması yaptık. Nörolog tarafından TİA tanısı konan hastalar dahil edildi. 38 hastanın elektrokardiyografi, manyetik rezonans görüntüleme ve karotis doppler ultrasonografi tetkik sonuçları; Acil servis sonuçları (hastaneye yatış, taburculuk), risk grubu dağılımı (ABCD2 puanlarına göre) ve bir yıllık tekrar olay insidansına ilişkin değişkenler karşılaştırıldı. Ayrıca hastaların serum kopeptin düzeyleri sağlıklı kontrollerle karşılaştırıldı. BulgularOrtalama kopeptin düzeyi hasta grubunda 435.80 ± 316.45 pg/ml iken kontrol grubunda 770.20 ± 912.53 pg/ml idi. TİA'lı hastaların ortalama kopeptin düzeyi anlamlı olarak daha düşüktü (p = 0.018). TİA tanısında tüm katılımcılarda kopeptin 386.28 pg/ml cut-off değerinde %60.53 duyarlılık ve %68.42 özgüllüğe sahipti. Ayrıca 60 yaş üstü katılımcılarda kopeptin 460.37 pg/ml cut-off değerinde %75.86 duyarlılık ve %72.41 özgüllüğe sahipti. SonuçBildiğimiz kadarıyla bu, bir serum biyobelirteçlerinin TİA tanısında yüksek etkinliğini gösteren ilk çalışmadır. Klinik şüphesi düşük ve kopeptin değeri düşük olan hastalarda acil hekimleri alternatif tanıları araştırmalıdır.
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