The usefulness of the percentage of immature granulocytes in predicting in-hospital mortality in patients with upper gastrointestinal bleeding

• Published in: The American journal of emergency medicine Vol. 46; pp. 646 - 650
• Main Authors: Narci, Hüseyin Narcı, Berkesoglu Mustafa Berkeşoğlu, Ucbilek, Enver Üçbilek, Ayrik Cüneyt Ayrık
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2021; Elsevier Limited
• Subjects: Age; Automation; Biomarkers; Bleeding; Blood platelets; Blood pressure; Comorbidity; Creatinine; Disease; Emergency medical care; Emergency medical services; Granulocytes; Heart rate; Hematemesis; Hemoglobin; Hospitals; Immature granulocytes; Immunoglobulins; Infections; Laboratories; Leukocytes (granulocytic); Mortality; Patients; Regression analysis; Upper gastrointestinal bleeding; United States > US; Upper gastrointestinal bleeding; Mortality; Immature granulocytes
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2020.12.039

Upper gastrointestinal bleeding (UGIB) is an important health problem with a potentially life threatening course. Measurement of immature granulocytes percentage (IG %), reflecting the fraction of circulating immature granulocyte (IG), is associated with increased mortality in patients with systemic inflammation, or distress. The aim of this study was to evaluate whether the IG% is an effective predictive marker for estimating the in-hospital mortality for patients with UGIB admitting to the emergency department (ED). This retrospective study included patients with UGIB who admitted to the ED, between 01.01.2019 and 31.12.2019. The patients were divided into two groups as discharged and dead. The IG% and other parameters were recorded. The primary end point of the study was in-hospital mortality. Logistic regression model was used to determine the factors affecting mortality. This study included 149 patients, 94 of whom were men. The mean age of the patients was 64.5 ± 14.2. Twenty patients died during hospitalization and 129 were discharged. IG% was significantly higher in patients who died compared with patients who discharged. In the receiver operating characteristic (ROC) curves analysis to determine the in-hospital mortality, the cut-off value (>1%) for IG% level was found specificity (93.8%), sensitivity (100%), positive predictive value (PPV = 71.43%), negative predictive value (NPV = 100.00%) and area under curve (AUC = 0.98). Univariate logistic regression analysis showed that IG% was predicting in-hospital mortality (odds ratio, OR = 65.6, confidence interval, CI = 2.00–2152.6). High IG% levels may be used as a predictor of in-hospital mortality in patients with UGIB.