The role of immature granulocyte count and delta neutrophil index in the early prediction of mesenteric ischemia

D. Durak, V.B. Turhan, E.G. Alkurt, M.B. Tutan, İ.T Şahiner

Bursa Yüksek İhtisas Training and Research Hospital, General Surgery Clinic, Bursa, Turkey. dogukandurak404@hotmail.com

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• Surgery

OBJECTIVE: Mesenteric ischemia is a fatal condition leading to ischemia and necrosis of the intestines following the interruption of blood flow in the vessels feeding the intestines. The present study investigated the significance of immature granulocyte count and delta neutrophil index in the early prediction of mesenteric ischemia.

PATIENTS AND METHODS: The study included 248 patients who applied to the hospital between 01.01.2020 and 01.04.2022 and underwent emergency and elective bowel resection in the general surgery clinic. The study population was divided into two groups as patients who underwent surgery for causes non-related to mesenteric ischemia (Group 1) and patients with findings of mesenteric ischemia who underwent laparotomy (Group 2). Preoperative immature granulocyte counts, and delta neutrophil index levels were compared between the groups with and without perioperative mesenteric ischemia.

RESULTS: No statistical difference was observed between the groups in terms of age or sex. Comparing the two groups regarding immature granulocyte count and delta neutrophil index revealed a statistically significant difference (p<0.001). The median immature granulocyte count was 0.04 (0.02-0.06) in Group 1 and 1.83 (0.18-2.5) in Group 2, with a statistically significant difference (p<0.001). Also, the comparison of delta neutrophil index levels revealed a median value of 0.4 (0.2-0.6) in Group 1 and 5.6 (0.7-8.1) in Group 2, with a statistically significant difference.

CONCLUSIONS: The results of this study have demonstrated that immature granulocyte counts, and delta neutrophil index levels are reliable markers that do not require any additional time or expense, can be easily measured in a complete blood count, and can be used for evaluating intestinal necrosis in mesenteric ischemia.

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