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Diagnostic utility of simple hematologic markers in acute gastroenteritis patients admitted to the emergency department

Okan Bardakci, Murat Das, Gokhan Akdur, Okhan Akdur Yavuz Beyazit.




Abstract

The contributions of hematologic parameters to the inflammatory response via different leukocyte and platelet pathways are well known. However, the diagnostic yield of these parameters in acute gastroenteritis (AGE) is not yet well understood. This study was planned to investigate the diagnostic value of simple hematological markers, including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR), in patients with AGE admitted to the emergency department. A total of 57 patients with AGE of either viral or bacterial origin and 69 age and sex-matched control subjects were studied. NLR, PLR, MPV, PDW, and RDW values in all patients were calculated and recorded from complete blood cell counts. A total of 126 patients (57 men [45.2%] and 69 women [54.8%]) were included in the study. The mean NLR and PLR values of AGE patients were significantly higher than those of health controls (NLR = 4.44 ± 4.1 for AGE patients and 2.22 ± 1.2 for controls [P < 0.001]; PLR = 160.4 ± 102.4 for AGE patients and 113.8 ± 42.6 for controls [P = 0.02]. ROC curve analysis suggested that the optimum NLR cut-off point for AGE was 2.08, with a sensitivity, specificity, PPV, and NPV of 70%, 65%, 62%, and 72%, respectively (AUC = 0.704). The optimum PLR cut-off point for AGE was 105.55, with sensitivity, specificity, PPV, and NPV of 71%, 50%, 54%, and 68%, respectively (AUC = 0.648). We demonstrated that NLR and PLR levels are elevated in AGE patients. Thus, NLR and PLR levels can be considered a valuable tool to differentiate acute gastroenteritis from other non-inflammatory emergent conditions.

Key words: Acute gastroenteritis, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio






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