Neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio use in detecting bowel ischaemia in adhesional small bowel obstruction

Woodford, Evangeline; Woodford, Hannah; Hort, Amy; Pang, Tony; Lam, Vincent; Nahm, Christopher B.

doi:10.1111/ans.18073

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…Laboratory test values such as lactate, liver enzymes, C-reactive protein, and lymphocytes, among others, have been investigated to identify markers of intestinal ischemia/necrosis. [3][4][5][6]29,30 Although markers of intestinal ischemia such as i-FABP, D-lactate, and SM22 have been recently reported, 2,8-11 their clinical application has not gained widespread acceptance. Because of its simplicity, PGE-MUM measurements can be easily applied to the assessment of intestinal ischemia as it is already being used clinically in patients with UC.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prostaglandin E-major urinary metabolites as a new biomarker for acute mesenteric ischemia

Suzuki,

Morishita,

Adachi

et al. 2024

J Trauma Acute Care Surg

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Background Acute mesenteric ischemia (AMI) is an emergent vascular disease caused by cessation of the blood supply to the small intestine. Despite advances in the diagnosis, intervention, and surgical procedures, AMI remains a life-threatening condition. Prostaglandin E2 Major Urinary Metabolite (PGE-MUM), the urinary metabolite of Prostaglandin E2, is known to be stable in urine and has been suggested to be a valuable biomarker for intestinal mucosal inflammation, such as ulcerative colitis. We therefore investigated whether or not PGE-MUM levels reflect the degree of ischemia in an intestinal ischemia-reperfusion (IR) model. Methods Male rats were used to establish a superior mesenteric artery occlusion (SMAO) group, in which the superior mesenteric artery was clamped, and a sham group. The clamping times in the SMAO group were either 30 or 60 min, and reperfusion times were either 3 or 6 h, after which PGE-MUM values were measured. Results The histological injury score of the SMAO (30-min ischemia and 6-h reperfusion group: 1.8 ± 0.4 and 60-min ischemia and 6-h reperfusion group: 4.7 ± 0.5) and were significantly greater than that of the sham group (0.4 ± 0.7, p < 0.05). The PGE-MUM levels in the SMAO group (30-min ischemia and 6-h reperfusion group:483 ± 256 and 60-min ischemia and 6-h reperfusion group:889 ± 402 ng/mL) were significantly higher than in the sham group (30-min and 6-h observation group:51 ± 20, and 60-min and 6-h observation group:73 ± 32 ng/mL p < 0.05). Furthermore, the PGE-MUM value was corrected by the concentration of urinary creatinine (Cr). The PGE-MUM/urinary Cr levels in the SMAO group were also significantly higher than in the sham group (p < 0.05). Conclusions We found that intestinal IR increased urinary PGE-MUM levels depending on the ischemic time. This suggests the potential utility of PGE-MUM as a noninvasive marker of intestinal ischemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prostaglandin E-major urinary metabolites as a new biomarker for acute mesenteric ischemia

Suzuki,

Morishita,

Adachi

et al. 2024

J Trauma Acute Care Surg

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“…NLR, MLR, and PLR are simple indices of the systemic inflammatory response and have been confirmed to be associated with intestinal problems, such as Crohn disease (CD), ulcerative colitis (UC), and acute intestinal obstruction. [28][29][30] This study aimed to investigate In this study, the dose-volume of the bowelbag and rectum were related to the occurrence of grade ≥ 2 ARE, and bowelbag V5 and V40 were independent risk factors for acute radiation enteritis. In our opinion, 3DCRT versus IMRT for ARE is essentially a comparison of the intestinal irradiation dose.…”

Section: Discussionmentioning

confidence: 99%

“…Complete blood count is a routine, inexpensive, and simple examination that provides information about blood components. NLR, MLR, and PLR are simple indices of the systemic inflammatory response and have been confirmed to be associated with intestinal problems, such as Crohn disease (CD), ulcerative colitis (UC), and acute intestinal obstruction 28–30 . This study aimed to investigate whether NLR, MLR, and PLR can be used as novel noninvasive biomarkers for the risk of grade ≥2 ARE.…”

Section: Discussionmentioning

confidence: 99%

“…NLR, MLR, and PLR are simple indices of the systemic inflammatory response and have been confirmed to be associated with intestinal problems, such as Crohn disease (CD), ulcerative colitis (UC), and acute intestinal obstruction. 28 – 30 This study aimed to investigate whether NLR, MLR, and PLR can be used as novel noninvasive biomarkers for the risk of grade ≥2 ARE. This study found that patients with MLR ≥ 0.82 or PLR < 307.50 after RT had a higher proportion of grade ≥2 ARE.…”

Section: Discussionmentioning

confidence: 99%

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Nomogram Predicting Grade ≥2 Acute Radiation Enteritis in Patients With Cervical Cancer Receiving Concurrent Chemoradiotherapy

Chen,

Gong,

Zhang

et al. 2024

American Journal of Clinical Oncology

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Purpose: To analyze the risk factors for grade ≥2 ARE in patients with cervical cancer receiving concurrent chemoradiotherapy. Methods: A total of 273 patients with cervical cancer receiving concurrent chemoradiotherapy at our hospital were retrospectively enrolled. The patients were divided into training and validation groups. Clinical parameters were analyzed using univariate analysis and multivariate logistic regression analysis. A nomogram model was established based on the independent risk factors selected using multivariate logistic regression. The areas under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram. The patients were divided into low-score and high-score groups based on the scores calculated using the nomogram model and compared. Results: Malnutrition, monocyte-lymphocyte ratio ≥0.82 after radiotherapy, platelet-lymphocyte ratio <307.50 after radiotherapy, and bowelbag volume receiving at least 5 and 40 Gy were independent risk factors for grade ≥2 ARE and were incorporated into the nomogram (P<0.05). The ROC curve, calibration curve, and DCA suggested that the nomogram had good discrimination, concordance, and net benefit in the clinical. A medium nomogram score of 146.50 points was used as the cutoff point, and the incidence of grade ≥2 ARE in the high-score group was higher than that in the low-score group (P<0.05). Conclusion: The nomogram model for grade ≥2 ARE has good predictive ability and clinical utility, and is convenient for clinicians to identify high-risk groups and develop early prevention and treatment strategies.

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Neutrophil to lymphocyte ratio predicts bowel ischemia in non-strangulated adhesive small bowel occlusions: a retrospective analysis from an acute care surgical service

Friziero,

Rosso,

Zuin

et al. 2024

BMC Surg

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Background Adhesive small bowel obstruction (ASBO) is a leading cause of hospitalization in emergency surgery. The occurrence of bowel ischemia significantly increases the morbidity and mortality rates associated with this condition. Current clinical, biochemical and radiological parameters have poor predictive value for bowel ischemia. This study is designed to ascertain predictive elements for the progression to bowel ischemia in patients diagnosed with non-strangulated ASBO who are initially managed through conservative therapeutic approaches. Methods The study was based on the previously collected medical records of 128 patients admitted to the Department of Acute Care Surgery of Padua General Hospital, from August 2020 to April 2023, with a diagnosis of non-strangulated adhesive small bowel obstruction, who were then operated for failure of conservative treatment. The presence or absence of bowel ischemia was used to distinguish the two populations. Clinical, biochemical and radiological data were used to verify whether there is a correlation with the detection of bowel ischemia. Results We found that a Neutrophil-Lymphocyte ratio (NLR) > 6.8 (OR 2.9; 95% CI 1.41–6.21), the presence of mesenteric haziness (OR 2.56; 95% CI 1.11–5.88), decreased wall enhancement (OR 4.3; 95% CI 3.34–10.9) and free abdominal fluid (OR 2.64; 95% CI 1.08–6.16) were significantly associated with bowel ischemia at univariate analysis. At the multivariate logistic regression analysis, only NLR > 6.8 (OR 5.9; 95% CI 2.2–18.6) remained independent predictive factor for small bowel ischemia in non-strangulated adhesive small bowel obstruction, with 78% sensitivity and 65% specificity. Conclusions NLR is a straightforward and reproducible parameter to predict bowel ischemia in cases of non-strangulated adhesive small bowel obstruction. Employing NLR during reevaluation of patients with this condition, who were initially treated conservatively, can help the acute care surgeons in the early prediction of bowel ischemia onset.

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Neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio use in detecting bowel ischaemia in adhesional small bowel obstruction

Cited by 7 publications

References 16 publications

Prostaglandin E-major urinary metabolites as a new biomarker for acute mesenteric ischemia

Prostaglandin E-major urinary metabolites as a new biomarker for acute mesenteric ischemia

Nomogram Predicting Grade ≥2 Acute Radiation Enteritis in Patients With Cervical Cancer Receiving Concurrent Chemoradiotherapy

Neutrophil to lymphocyte ratio predicts bowel ischemia in non-strangulated adhesive small bowel occlusions: a retrospective analysis from an acute care surgical service

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