Can direct bilirubin-to-lymphocyte ratio predict surgery for pediatric adhesive small bowel obstruction?
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Tarih
2024
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Mexican Acad Surgery
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: Estimating which patients might require surgical intervention is crucial. Patients with complete bowel obstructions exhibit disrupted enterohepatic cycles of bile and bacteremia due to bacterial translocation. The goal of this study was to develop a prediction index using laboratory inflammatorydatato identifypatients who mayneed surgery. Materials and methods: The patients were divided into two groups based on their management strategy: Non -operative management (Group 1) and surgical management (Group 2). Results: The indirect bilirubin, direct bilirubin, and total bilirubin were significantly higher in Group 2 than in Group 1 (p = 0.001, p < 0.001, and p < 0.001, respectively). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-NLR (PNLR), and direct bilirubin-to-lymphocyte ratio (DBR) were significantly higher in Group 2 compared to Group 1 (p = 0.041, p = 0.020, and p < 0.001, respectively). In group 2, 78% have viable bowels. Resection was performed in 40% of cases, with 12% mortality and a 10 -day average hospital stay. DLR performs the best overall accuracy (72%), demonstrating a well-balanced sensitivity (62%) and specificity (81%). Conclusions: This study suggested that DBR is a more accurate predictive index for surgical intervention in pediatric adhesive small bowel obstruction patients compared to NLR and PNLR, providing valuable guidance for treatment strategies.
Açıklama
Anahtar Kelimeler
Neutrophil-to-lymphocyte ratio., Platelet-to-neutrophil-to-lymphocyte ratio, Direct bilirubin-to-lymphocyte ratio, Adhesive small bowel obstruction
Kaynak
Cirugia Y Cirujanos
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
92
Sayı
3
