The Value of Immature Granulocyte and Immature Granulocyte/Total Granulocyte Ratio in Predicting the Need for Surgical Treatment in Patients Diagnosed with Intestinal Ileus in the Emergency Department

Abstract

Background/Aims: Although many biomarkers that can predict the need for surgical treatment of patients with intestinal ileus have been investigated, effective, inexpensive, and fast-resulting biomarkers have not been determined. In our study, showing the value of immature granulocyte (IG) and immature granulocyte/total granulocyte (IG/TG) ratio in predicting the need for surgical treatment in patients diagnosed with intestinal ileus in the emergency department was aimed. Methods: Our study was carried out as a prospective cohort between 23.11.2021 and 07.04.2022. Patients aged 18 years and older who applied to the emergency department and were diagnosed with intestinal ileus after clinical, laboratory and radiological evaluation were included in the study. Demographic characteristics, comorbidities, treatments, laboratory tests and IG, IG/TG results of the patients were recorded. The patients were divided into two groups as those who underwent surgical treatment and those who did not, and comparisons were made. p value <0.05 was considered statistically significant. Results: A total of 78 patients were included in the study. 46.2% (n=36) of the patients were female and the median age was 65 years. While surgery was performed in 41% (n=32) of the patients, 59% (n=46) were followed up with medical treatment. IG number and IG/TG ratio were found to be higher in patients who underwent surgical intervention than in those who underwent medical treatment, and these differences were statistically significant (p<0.05). In receiver-operating characteristic (ROC) analysis AUC: 0.658 was found for IG number. With the best cut-off value of 0.03, the sensitivity was found to be 56.3% specificity: 71.7%; and the AUC value for IG/TG: 0.627 (95% CI; 0.500-0.753), and when the best cut-off value was taken as 0.2, the sensitivity for this value was 59.4%, and the specificity was 63%. Conclusion: In this study, in which we examined the IG numbers and IG/TG ratios in patients with intestinal ileus, although we showed that these parameters were higher in patients who needed surgical treatment, upon the analysis done, we believe that it is not a clinically significant marker.