ADLİ TRAVMATOLOJİK AÇIDAN YARALANMANIN AĞIRLIĞINI BELİRLEMEDE NÖTROFİL LENFOSİT ORANI VE TROMBOSİT LENFOSİT ORANININ ROLÜ The role of Neutrophil-to-Lymphocyte Ratio and Plateletto-Lymphocyte Ratio for determination of injury severity in forensic traumatology

OZET Amac: Notrofil lenfosit orani (NLO) ve trombosit lenfosit orani (TLO) sistemik inflamasyonu gosteren biyobelirteclerdir. Bu calismanin amaci, adli travmatolojik acidan yaralanmanin agirliginin belirlenmesinde, NLO ve TLO’nin rolunu tartismaktir. Gerec ve yontem: Bir universite hastanesi tibbi biyokimya laboratuarinda, 01.06.2015-01.11.2015 tarihlerinde etanol analizi yapilmis olan olgular, hastane otomasyon sistemi uzerinden retrospektif olarak belirlendi. Veriler, hastalarin elektronik dosyalarindan elde edildi. Olgularin, sosyodemografik ozellikleri, yaralanmanin agirligi/derecesi, etanol duzeyi, NLO ve TLO degerleri incelendi. Veriler SPSS programinda analiz edildi. Bulgular: Incelenen 155 hastanin 133’u (%85,8) erkek olup yas ortalamasi 36,6± 15,4 yildi. YT olan olgularda NLO ortalamasi 9,4±10,9, YT olmayan olgularda 5,1±5,1 saptandi, bu fark istatistiksel anlamli degildi (p>0,05). Basit tibbi mudahale (BTM) ile giderilemeyen olgularin NLO ortalamasi 8,6±8,6 olup, BTM ile giderilebilir ve travmatik degisim olmayan gruplara gore daha yuksekti ve Bonferroni duzeltmeli Mann Witney U testine gore bu farklar anlamliydi (p=0,0001). Kirik saptanan olgularda NLO ortalamasi 8,9±9,4 iken, kirik saptanmayan olgulara gore daha yuksekti ve bu fark istatistiksel olarak anlamliydi (p=0,002). TLO ortalama degerleri ile gruplar arasinda, istatistiksel anlamli fark saptanmadi (p>0,05). Sonuc: Yuksek NLO degerleri ile yaralanmanin agirligi arasinda anlamli bir iliski mevcuttur. TLO’na gore NLO, adli travmatolojik acidan yaralanmanin agirligini belirlemede yardimci bir biyobelirtec olarak kullanilabilir. Bu iliskinin patofizyolojisinin anlasilmasi icin, daha fazla arastirma yapilmasi gereklidir. Anahtar Kelimeler: Adli tip; Yaralanmanin derecesi; NLO; TLO ABSTRACT Objectives: Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are the biological markers that show the systematic inflammation. The aim of this study is to suggest the role of NLR and PLR in order to determine the injury severity in forensic traumatology. Methods: The patients whose ethanol analyses were done by the hospital automation system between 01.06.2015 and 01.11.2015 at the biochemistry laboratory of the university hospital, were retrospectively determined. The data were collected from the electronic patient files. The socio-demographic characteristics, the severity of the injury, the level of ethanol, NLR and PLR of the data were analysed. The analyses was made by SPSS. Results: 133 of the 155 (85.8%) patients were male and the mean age was 36.6± 15.4 year. The mean NLR of the injuries which cannot be treated with a simple medical intervention was 8.6±8.6 and it was higher than the groups with the injuries which can be treated with a simple medical intervention and without a traumatic change; this difference was statistically significant according to the Mann Witney U test with Bonferroni correction (p=0.0001). At the cases with fractures the mean NLR was 8.9±9.4 and it was higher than the ones without any fracture and this difference was also statistically significant (p=0.002). Conclusion: There is a relationship between high NLR and the severity of injury. NLR can be used as a biological marker to estimate the severity of injury better than the PLR. In order to understand the pathophysiology of the relationship more research should be done. Key Words: Forensic medicine; Injury severity; NLR; PLR