Evaluation of prognosis by complete blood parameters in patients with acute pulmonary embolism

Background: Acute pulmonary embolism is associated with high death and morbidity. During a pulmonary embolism, neutrophils infiltrate the right ventricular wall, inflammatory mediators are released, and necrosis develops. This study aimed to compare the effectiveness of whole blood parameters mean platelet volume (MPV), mean platelet volume to platelet ratio (MPVPR), neutrophils (NEU), neutrophil-tolymphocyte platelet ratio (NLPR), neutrophil to lymphocyte ratio (NLR), neutrophil to platelet ratio (NPR), platelets (PLT), platelet mass index (PMI), and systemic immuneinflammatory index (SII) in predicting mortality in patients with acute pulmonary embolism. Methods: We retrospectively analyzed 112 patients diagnosed with acute pulmonary embolism at Dicle University Hospital's emergency department between January 2016 and December 2022. Receiver operating characteristic (ROC) curve analysis was used to examine the diagnostic decision properties of the variables used in mortality prediction. Results: 103 (91.96%) of the patients survived and 9 (8.04%) died. As a result, the best parameters for predicting mortality outcomes were NLPR (area under the curve (AUC): 0.887, sensitivity: 88.89%, specificity: 84.47%, positive predictive value (PPV): 33.33%, negative predictive value (NPV): 98.86%), NPR (AUC: 0.828, sensitivity: 77.78%, specificity: 91.26%, PPV: 43.75%, NPV: 97.92%), NLR (AUC: 0.803, sensitivity: 88.89%, specificity: 60.19%, PPV: 16.33%, NPV: 98.41%) respectively. Conclusions: This study found that NLPR, NPR and NLR were the most accurate complete blood parameters for predicting mortality in acute pulmonary embolism patients admitted to the emergency department.