Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers

Esra Adıyeke; Levent Adıyeke

doi:10.28982/josam.739227

Authors

Esra Adıyeke https://orcid.org/0000-0003-4940-1553
Levent Adıyeke https://orcid.org/0000-0003-3014-3582

DOI:

https://doi.org/10.28982/josam.739227

Keywords:

Intensive care unit, Pressure ulcer, Neutrophil to lymphocyte ratio, Mean platelet volume, Inflammation

Abstract

Aim: Inflammation may have deleterious effects on tissue healing. Pressure ulcers impair the quality of life of the patients admitted to intensive care unit (ICU) besides increasing the health costs. Neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are simple and readily available markers proinflammatory state. This study aimed to investigate whether measurement of admission NLR and MPV could be useful in identification of the patients who are at elevated risk for the development of the pressure ulcers.
Methods: This retrospective cohort study evaluated 104 patients admitted to the intensive care unit of a tertiary center. Patients were divided into two groups according to the presence of pressure ulcers as follows: Patients without pressure ulcers throughout hospitalization and patients who developed pressure ulcers while hospitalized. The two groups were compared with respect to the demographic features and complete blood count parameters at admission.
Results: The NLR [8.8 (6.6) vs. 5.3 (2.6), P<0.001], platelet to lymphocyte ratio [322(125) vs. 234(116), P=0.023] and MPV [10.5 (1.5) fl vs. 9.8 (1.1) fl, P<0.001] were significantly higher, and length of ICU stay was significantly longer in patients with pressure ulcers than those without [16.1 (3.8) days vs. 12.5 (2.9) days, P<0.001]. Logistic regression analysis revealed that age (P=0.03), length of ICU stay (P=0.01), NLR (P=0.01) and MPV (P=0.01) were significantly predictive for the presence of pressure ulcers.
Conclusions: Our findings indicate that age, length of ICU stay, and NLR, and MPV, which are indicative for the preexisting inflammatory state, are independent predictors for the development of pressure ulcers in patients admitted to the ICU

Downloads

Download data is not yet available.

References

McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database of Syst Rev. 2015:Cd001735.

Tescher AN, Branda ME, Byrne TJ, Naessens JM. All at-risk patients are not created equal: analysis of Braden pressure ulcer risk scores to identify specific risks. J Wound Ostomy Continence Nurs. 2012;39:282-91.

Kaya BB. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. 2019;3(7):512-4.

Magri CJ, Tian TX, Camilleri L, Xuereb R, Galea J, Fava S. Red blood cell distribution width and myocardial scar burden in coronary artery disease. Postgrad Med J. 2017;93:607-12.

Maruyama Y, Inoue K, Mori K, Gorai K, Shimamoto R, Onitsuka T, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol. 2017;137:106-10.

Serbest S, Tiftikci U, Tosun HB, Gumustas SA, Uludag A. Is there a relationship between fracture healing and mean platelet volume? Ther Clin Risk Manag. 2016;12:1095-9.

Demarre L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J, et al. The cost of prevention and treatment of pressure ulcers: A systematic review. Int J Nurs Stud. 2015;52:1754-74.

Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. J Clin Nurs. 2010;19:414-21.

Jiang Q, Li X, Qu X, Liu Y, Zhang L, Su C, et al. The incidence, risk factors and characteristics of pressure ulcers in hospitalized patients in China. Int J Clin Exp Pathol. 2014;7:2587-94.

Collier M. Pressure ulcer prevention: fundamentals for best practice. Acta Medica Croatica: 2016;70 Suppl 1:3-10.

Lumbers M. Pressure ulcers: an overview of risk. Br J Nurs. 2017;26:S49-S50.

Spruce L. Back to Basics: Preventing Perioperative Pressure Injuries. AORN J. 2017;105:92-9.

Blenman J, Marks-Maran D. Pressure ulcer prevention is everyone's business: the PUPS project. Br J Nurs. 2017;26:S16-S26.

Sving E, Fredriksson L, Gunningberg L, Mamhidir AG. Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting. J Clin Nurs. 2017;26:3200-11.

Cullum N, Deeks JJ, Fletcher AW, Sheldon TA, Song F. Preventing and treating pressure sores. Qual Health Care.1995;4:289-97.

Lima-Serrano M, Gonzalez-Mendez MI, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Med Intensiva. 2018;42:82-91.

Gonzalez-Mendez MI, Lima-Serrano M, Martin-Castano C, Alonso-Araujo I, Lima-Rodriguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27:1028-37.

Lima S, Gonzalez M, Carrasco C, Lima R. Risk factors for pressure ulcer development in Intensive Care Units: A systematic review. Med Intensiva. 2017;41:339-46.

Borsting TE, Tvedt CR, Skogestad IJ, Granheim TI, Gay CL, Lerdal A. Prevalence of pressure ulcer and associated risk factors in middle- and older-aged medical inpatients in Norway. J Clin Nurs. 2018;27:e535-e43.

Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, et al. Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013;50:974-1003.

Zhou Q, Yu T, Liu Y, Shi R, Tian S, Yang C, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs.2018;27:694-704.

Garraud O, Hamzeh-Cognasse H, Pozzetto B, Cavaillon JM, Cognasse F. Bench-to-bedside review: Platelets and active immune functions - new clues for immunopathology? Crit Care. 2013;17:236.

Fernandez-Moure JS, Van Eps JL, Cabrera FJ, Barbosa Z, Medrano Del Rosal G, Weiner BK, et al. Platelet-rich plasma: a biomimetic approach to enhancement of surgical wound healing. Journal Surg Res. 2017;207:33-44.

Yıldırım ÖT, Akşit E, Aydın F, Aydın AH, Dağtekin E. Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure? J Surg Med. 2019;3(1):4-7.

Uysal P, Tuncel T, Olmez D, Babayigit A, Karaman O, Uzuner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227- 30.

Yuksel O, Helvaci K, Basar O, Koklu S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20:277-81.

Yazici S, Yazici M, Erer B, Erer B, Calik Y, Ozhan H, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122-5.

Akça A, Yılmaz G, Köroğlu N. Platelet Indices as the Predictor of Antibiotics Response in Surgical Wound Infections Following Total Abdominal Hysterectomy. Sisli Etfal Hast Tip Bul. 2019;53:132-6.

Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016;22:405-11.

Dong CH, Wang ZM, Chen SY. Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis. Clin Biochem. 2018;52:131-6.

Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10:12.