The role of MPV/albumin ratio in determining disease severity in acute cholangitis in the emergency medicine

Abstract

Background: We aimed to examine the relationship of mean platelet volume (MPV) / albumin ratio (MAR) with disease and disease severity in patients with acute cholangitis. Material and Method: Cases older than 18 years of age, who applied to the emergency department and were diagnosed with acute cholangitis after detailed evaluation were included in the study.Tokyo 2018 criteria are used to determine the severity of acute cholangitis. Result: There was a positive correlation between MAR levels and Tokyo severity,and increased MAR levels were determined as an independent predictor for each risk group.The cut-off value of the MAR level in predicting moderate risk compared to the mild risk group was found to be >20.9% with 73.3% sensitivity and 70.6% specificity (AUC±SE=0.785±0.03; +PV= 51.3%, -PV= 86.2%; p< 0.001). The cut-off value of the MAR level in predicting severe risk compared to the moderate risk group was found to be >23.2% with 77.2% sensitivity and 59.1% specificity (AUC±SE=0.744±0.03; +PV= 64.5%, -PV= 72.9%; p<0.001).Mean MAR levels were found to be higher in patients admitted to the ICU compared to those who were not admitted (25.2±6.0 vs 21.3±4.6; p<0.001) and increased MAR levels were a potential risk factor for mortality (HR= 1.09; p<0.001). Conclusion: We found that the MAR level is a very good marker in determining the severity of acute cholangitis.