AI Article Synopsis

  • The study investigates the use of white blood cell count, platelet count, and fibrinogen levels as additional tools for assessing the pre-test probability of acute aortic syndromes (AAS) in patients who are initially classified as low probability based on standard clinical evaluations.! -
  • Conducted on 1210 patients in an Emergency Department, the research found that among those with low probability, specific abnormalities in blood counts were linked to a high sensitivity for diagnosing AAS, with white blood cell count and platelet count emerging as strong independent predictors.! -
  • Results showed that the estimated risk of having AAS increased with the number of abnormal test results, indicating these blood markers could help refine risk assessment and potentially guide imaging decisions in

Article Abstract

Aims: Pre-test probability assessment is key in the approach to suspected acute aortic syndromes (AASs). However, most patients with AAS-compatible symptoms are classified at low probability, warranting further evaluation for decision on aortic imaging. White blood cell count, platelet count and fibrinogen explore pathophysiological pathways mobilized in AASs and are routinely assayed in the workup of AASs. However, the diagnostic performance of these variables for AASs, alone and as a bundle, is unknown. We tested the hypothesis that white blood cell count, platelet count and/or fibrinogen at presentation may be applied as additional tools to standard clinical evaluation for pre-test risk assessment in patients at low probability of AAS.

Methods And Results: This was a retrospective observational study conducted on consecutive patients managed in our Emergency Department from 2009 to 2014 for suspected AAS. White blood cell count, platelet count and fibrinogen were assayed during evaluation in the Emergency Department. The final diagnosis was obtained by computed tomography angiography. The pre-test probability of AAS was defined according to guidelines. Of 1210 patients with suspected AAS, 1006 (83.1%) were classified at low probability, and 271 (22.4%) were diagnosed with AAS. Within patients at low probability, presence of at least one alteration among white blood cell count >9*10/µl, platelet count <200*10/µl and fibrinogen <350 mg/dl was associated with a sensitivity of 95.5% (89.7-98.5%) and a specificity of 18.3% (15.6-21.2%). In patients at low probability, white blood cell count >9*10/µl and platelet count <200*10/µl were found as independent predictors of AAS beyond established clinical risk markers. Within patients at low probability, the estimated risk of AAS based on the number of alterations amongst white blood cell count >9*10/µl and platelet count <200*10/µl was 2.7% (1.2-5.7%) with zero alterations, 11.3% (8.8-14.3%) with one alteration and 31.9% (24.8-40%) with two alterations ( p<0.001).

Conclusion: In addition to standard clinical evaluation, white blood cell count and platelet count may be used in patients at low pre-test probability to fine-tune risk assessment of AAS.

Download full-text PDF

Source
http://dx.doi.org/10.1177/2048872615600097DOI Listing

Publication Analysis

Top Keywords

white blood
20
blood cell
20
platelet count
20
low probability
20
cell count
16
patients low
12
count platelet
12
count
9
standard clinical
8
clinical evaluation
8

Similar Publications

Background And Objectives: This study aims to report the clinical, biological, and imaging features of cross-sectional study of neurosyphilis patients with leptomeningeal enhancement of spinal cord. Here, 51 neurosyphilis patients with leptomeningeal enhancement of spinal cord positivity are described, offering a promise in terms of early diagnosis, thereby enabling timely detection and treatment.

Methods: We retrospectively included all neurosyphilis patients enrolled in this study from December 2019 to January 2024.

View Article and Find Full Text PDF

Introduction: The relationship between the Enhanced Recovery After Surgery (ERAS) guidelines and inflammatory markers in laparoscopic surgery has garnered increasing attention. These recommendations are designed to minimize surgical stress and potentially improve recovery outcomes by modifying perioperative care.

Objective: This scoping review aims to evaluate the impact of ERAS recommendations on inflammatory markers in patients undergoing laparoscopic surgeries, identifying current research gaps and consolidating findings from existing studies.

View Article and Find Full Text PDF

A 46-year-old woman on peritoneal dialysis (PD) had cloudy peritoneal dialysis effluent that had persisted for 10 days by the time she visited our hospital. The white blood cell count in the effluent was elevated to 1500/μL, leading to a diagnosis of peritoneal dialysis-associated peritonitis. The effluent cleared within two days with treatment using cefazolin and ceftazidime, and the white blood cell count dropped to 0/μL by day 6.

View Article and Find Full Text PDF

Endometrial carcinomas in the isthmus are called lower uterine segment (LUS) cancers. It is a rare location among uterine cancers and is known to be associated with Lynch syndrome, which tends to occur at a young age. Preoperative diagnosis may be difficult due to its anatomical location, and the prognosis is poorer than that of uterine cancer in general.

View Article and Find Full Text PDF

Case Report: A case of infantile acute hyperleukocytic leukemia treated by leukapheresis.

Front Pediatr

December 2024

Department of Hematology and Oncology, Dalian Women and Children's Medical Group, Dalian, China.

Leukapheresis is a treatment used to reduce leukocytes to decrease the number of white blood cells in circulation and prevent the risks of hyperviscosity and cerebrovascular and pulmonary leukostasis. We present a case of pro-B-cell acute lymphoblastic leukemia (ALL) with hyperleukocytosis in a 6-month-old infant, characterized by a positive KMT2A/AFF1 fusion gene with a leukocyte count of 1,755 × 10/L. After two consecutive sessions of leukapheresis, the white blood cell count decreased to 55 × 10/L.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: