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A retrospective study to assess the utility of hematological marker (monocyte to large platelet ratio) to diagnose patients with pulmonary embolism
The investigators conducted a retrospective review of emergency department records of patients who presented with signs and symptoms suggestive of pulmonary embolism (PE) and underwent CT pulmonary angiography (CTPA) for diagnosis. Hematological laboratory findings obtained prior to any treatment were collected and compared between two groups based on CTPA results: those with confirmed PE (CT positive) and those without PE (CT negative).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pulmonary embolism | Group that is confirmed to have pulmonary embolism by positive CTPA finding filling defect. |
| |
| Non-Pulmonary embolism | Group that have pulmonary embolism diagnosis was excluded by negative CTPA finding. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Monocyte to Large Platelet Ratio (MLPR) | Diagnostic Test | Admission laboratory values were used to calculate the Monocyte-to-Large Platelet Ratio (MLPR) by dividing the absolute monocyte count by the large platelet count. These values were obtained from blood samples collected before any treatment was administered. |
| Measure | Description | Time Frame |
|---|---|---|
| Monocyte-to-Large Platelet Ratio (MLPR) | A ratio between monocyte absolute count and the large platelets count (MLPR) values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by area under the curve (AUC) , sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). | At emergency department admission (baseline lab measurement) before any treatment. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean platelet volume (MPV) | MPV values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by AUC, sensitivity, specificity, PPV, and NPV. | At emergency department admission (baseline lab measurement) before any treatment. |
| Neutrophil to Lymphocyte Ratio (NLR) |
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Inclusion Criteria:
Exclusion Criteria:
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Patients presenting to the emergency department with signs and symptoms of pulmonary embolism who underwent CT pulmonary angiography for diagnosis.
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| Name | Affiliation | Role |
|---|---|---|
| Reem H Elkabarity, Professor | Ain Shams University | Study Chair |
| Hadil M Abdelhamid, Professor | Ain Shams University | Study Director |
| Azza Lotfy, Professor | Ain Shams University | Study Director |
| Mohamed k Awad, Lecturer | Ain Shams University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University | Cairo | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28465447 | Background | Granger V, Faille D, Marani V, Noel B, Gallais Y, Szely N, Flament H, Pallardy M, Chollet-Martin S, de Chaisemartin L. Human blood monocytes are able to form extracellular traps. J Leukoc Biol. 2017 Sep;102(3):775-781. doi: 10.1189/jlb.3MA0916-411R. Epub 2017 May 2. | |
| 31410404 | Background | Moharamzadeh P, Rahmani F, Foroughifar S, Shahsavarinia K. Reliability of Platelet Indices for Diagnosing Pulmonary Embolism; a Brief Report. Adv J Emerg Med. 2019 Apr 28;3(3):e27. doi: 10.22114/ajem.v0i0.137. eCollection 2019 Summer. |
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| ID | Term |
|---|---|
| D011655 | Pulmonary Embolism |
| D004194 | Disease |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
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|
The ratio between absolute neutrophil and absolute lymphocytes count (NLR) values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by AUC, sensitivity, specificity, PPV, and NPV. |
| At emergency department admission (baseline lab measurement) before any treatment. |
| D-Dimer Levels | D-Dimer concentration values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by AUC, sensitivity, specificity, PPV, and NPV. | At emergency department admission (baseline lab measurement) before any treatment. |
| Platelet Distribution Width (PDW) | PDW values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by AUC, sensitivity, specificity, PPV, and NPV. | At emergency department admission (baseline lab measurement) before any treatment. |
| Platelet To Lymphocyte Ratio (PLR) | The ratio between total platelets count and absolute lymphocytes count (PLR) values compared between groups using Mann-Whitney U test; diagnostic accuracy evaluated by AUC, sensitivity, specificity, PPV, and NPV. | At emergency department admission (baseline lab measurement) before any treatment. |
| 26060464 | Background | Talay F, Ocak T, Alcelik A, Erkuran K, Akkaya A, Duran A, Demirhan A, Kar Kurt O, Asuk Z. A new diagnostic marker for acute pulmonary embolism in emergency department: mean platelet volume. Afr Health Sci. 2014 Mar;14(1):94-9. doi: 10.4314/ahs.v14i1.15. |
| 29112185 | Result | Bialas AJ, Kornicki K, Ciebiada M, Antczak A, Sitarek P, Milkowska-Dymanowska J, Piotrowski WJ, Gorski P. Monocyte to large platelet ratio as a diagnostic tool for pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease. Pol Arch Intern Med. 2018 Jan 31;128(1):15-23. doi: 10.20452/pamw.4141. Epub 2017 Nov 7. |
| D014652 |
| Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |