Immature Granulocyte Count and Percentage As New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding

Overview

Journal Indian J Crit Care Med

Specialty Critical Care

Date 2020 Nov 2

PMID 33132562

Citations 3

Authors

Cihan Bedel

Mustafa Korkut

Ali Avci

Ahmet Uzun

Affiliations

Soon will be listed here.

Abstract

Aims: Early identification of patients at risk of adverse outcomes may increase the survival rates in patients with upper gastrointestinal bleeding (UGIB), but this can be difficult to predict in emergencies. The aim of the study is to evaluate immature granulocyte (IG), which can be obtained from simple hemogram tests in patients with UGIB, in terms of clinical use and as a mortality marker.

Materials And Methods: The patients diagnosed with UGIB between March 1, 2019, and September 30, 2019, were evaluated retrospectively. Demographic characteristics, causes of hemorrhage, clinical presentations, hemogram, and biochemistry values at ED admission and 30-day mortality status of the patients were examined. We divided the patients into groups according to their mortality status, and the groups were compared among themselves in terms of parameters.

Results: A total of 213 patients who met the inclusion criteria were included in the study. Of these patients, 139 (65.3%) were male and the mean age was 65.05 ± 16.7 years. Fifteen (7%) of them were in the nonsurvival group, while 198 (93%) were in the survival group. The efficacy of both the IG count (IGC) and IG% in predicting mortality was statistically significant ( = 0.002, = 0.008, respectively). The sensitivity and specificity for the IGC were found as 60% and 84.4; for the IG%, they were found as 66.7% and 75.7%, respectively.

Conclusion: IGC and IG% are independent risk factors for the 30-day mortality status. These measurements are obtained from simple hemogram tests and may be useful for the evaluation of mortality in patients with UGIB.

How To Cite This Article: Bedel C, Korkut M, Avcı A, Uzun A. Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding. Indian J Crit Care Med 2020;24(9):794-798.

Citing Articles

Old and New Biomarkers in Idiopathic Recurrent Acute Pericarditis (IRAP): Prognosis and Outcomes.

Mascolo R, Bizzi E, Martelli M, Facoetti C, Colazzo G, Barone F Curr Cardiol Rep. 2025; 27(1):17.

PMID: 39798014 PMC: 11724782. DOI: 10.1007/s11886-024-02170-y.

Echocardiographic epicardial fat thickness and immature granulocyte are novel inflammatory predictors of acute ischemic stroke: a prospective study.

Korkut M, Selvi F, Bedel C Sao Paulo Med J. 2022; 140(3):384-389.

PMID: 35508005 PMC: 9671256. DOI: 10.1590/1516-3180.2021.0461.R1.16082021.

Usefulness of Immature Granulocytes as A Prognostic Factor in ST-Elevation Myocardial Infarction.

Korkut M, Bedel C, Sivil R, Arslan M, Selvi F, Kus G Braz J Cardiovasc Surg. 2022; 37(6):893-899.

PMID: 35436073 PMC: 9713666. DOI: 10.21470/1678-9741-2021-0088.

Is Immature Granulocyte Count a Potential Prognostic Marker for Upper Gastrointestinal Tract Bleeding? A New Road to Explore.

Prabu N, Patil V Indian J Crit Care Med. 2020; 24(9):750-752.

PMID: 33132553 PMC: 7584830. DOI: 10.5005/jp-journals-10071-23606.

References

Zou Y, Zhang W, Huang C, Zhu Y . Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors. Exp Ther Med. 2019; 18(3):1533-1538. PMC: 6676203. DOI: 10.3892/etm.2019.7778. View

Barkun A, Bardou M, Martel M, Gralnek I, Sung J . Prokinetics in acute upper GI bleeding: a meta-analysis. Gastrointest Endosc. 2010; 72(6):1138-45. DOI: 10.1016/j.gie.2010.08.011. View

Karon B, Tolan N, Wockenfus A, Block D, Baumann N, Bryant S . Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem. 2017; 50(16-17):956-958. DOI: 10.1016/j.clinbiochem.2017.05.014. View

Martinez-Cara J, Jimenez-Rosales R, Ubeda-Munoz M, de Hierro M, de Teresa J, Redondo-Cerezo E . Comparison of AIMS65, Glasgow-Blatchford score, and Rockall score in a European series of patients with upper gastrointestinal bleeding: performance when predicting in-hospital and delayed mortality. United European Gastroenterol J. 2016; 4(3):371-9. PMC: 4924428. DOI: 10.1177/2050640615604779. View

Nahm C, Choi J, Lee J . Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis. Ann Clin Lab Sci. 2008; 38(3):241-6. View

Ko B, Kim Y, Jung D, Sohn C, Seo D, Lee Y . Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleedin. J Clin Med. 2019; 8(1). PMC: 6352164. DOI: 10.3390/jcm8010037. View

Hajiagha Mohammadi A, Azizi M . Prognostic factors in patients with active non-variceal upper gastrointestinal bleeding. Arab J Gastroenterol. 2019; 20(1):23-27. DOI: 10.1016/j.ajg.2019.01.001. View

Ayres L, Sgnaolin V, Munhoz T . Immature granulocytes index as early marker of sepsis. Int J Lab Hematol. 2019; 41(3):392-396. DOI: 10.1111/ijlh.12990. View

Shahrami A, Ahmadi S, Safari S . Full and Modified Glasgow-Blatchford Bleeding Score in Predicting the Outcome of Patients with Acute Upper Gastrointestinal Bleeding; a Diagnostic Accuracy Study. Emerg (Tehran). 2018; 6(1):e31. PMC: 6036534. View

10.

Garcia-Iglesias P, Villoria A, Suarez D, Brullet E, Gallach M, Feu F . Meta-analysis: predictors of rebleeding after endoscopic treatment for bleeding peptic ulcer. Aliment Pharmacol Ther. 2011; 34(8):888-900. DOI: 10.1111/j.1365-2036.2011.04830.x. View

11.

Gayret O, Erol M, Nacaroglu H . The Relationship of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio with Gastrointestinal Bleeding in Henoch-Schonlein Purpura. Iran J Pediatr. 2017; 26(5):e8191. PMC: 5297442. DOI: 10.5812/ijp.8191. View

12.

Koseoglu Z, Ozkan O, Semerci E, Aslan A, Yetim I, Ucar E . The relationship between mortality and inflammation in patients with gastrointestinal bleeding. J Int Med Res. 2009; 37(5):1508-14. DOI: 10.1177/147323000903700528. View

13.

Fouad T, Abdelsameea E, Abdel-Razek W, Attia A, Mohamed A, Metwally K . Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post-therapeutic outcome and prognostic indicators. J Gastroenterol Hepatol. 2019; 34(9):1604-1610. DOI: 10.1111/jgh.14659. View

14.

Sauneuf B, Bouffard C, Cornet E, Daubin C, Desmeulles I, Masson R . Immature/total granulocyte ratio: a promising tool to assess the severity and the outcome of post-cardiac arrest syndrome. Resuscitation. 2014; 85(8):1115-9. DOI: 10.1016/j.resuscitation.2014.04.017. View

15.

Monteiro S, Curdia Goncalves T, Magalhaes J, Cotter J . Upper gastrointestinal bleeding risk scores: Who, when and why?. World J Gastrointest Pathophysiol. 2016; 7(1):86-96. PMC: 4753192. DOI: 10.4291/wjgp.v7.i1.86. View

16.

Mortaz E, Alipoor S, Adcock I, Mumby S, Koenderman L . Update on Neutrophil Function in Severe Inflammation. Front Immunol. 2018; 9:2171. PMC: 6190891. DOI: 10.3389/fimmu.2018.02171. View

17.

Yune H, Chung S, Park Y, Chung H, Lee H, Lee J . Delta neutrophil index as a promising prognostic marker in out of hospital cardiac arrest. PLoS One. 2015; 10(3):e0120677. PMC: 4370748. DOI: 10.1371/journal.pone.0120677. View

18.

Badipatla K, Jadhav P, Vaddigiri S, Bajantri B, Singh A, Chandrala C . Predictors of acute gastrointestinal bleeding in diabetic ketoacidosis: a retrospective observational study in minority population. Gastroenterol Rep (Oxf). 2017; 5(4):293-297. PMC: 5691351. DOI: 10.1093/gastro/gox006. View

19.

Kolaczkowska E, Kubes P . Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol. 2013; 13(3):159-75. DOI: 10.1038/nri3399. View

20.

Tsai J, Lee C, Subeq Y, Lee R, Hsu B . Calcitriol decreases pro-inflammatory cytokines and protects against severe hemorrhagic shock induced-organ damage in rats. Cytokine. 2016; 83:262-268. DOI: 10.1016/j.cyto.2016.05.008. View