From dyspepsia to complicated peptic ulcer: new markers in diagnosis and prognosis

A. Atay, F. Karahan, O. Gunes, S. Gunay, O.N. Dilek

Department of General Surgery, Department of Gastroenterology, Izmir Katip Celebi University Atatürk Training and Research Hospital, Izmir, Turkey. atayarif@hotmail.com

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• Surgery

OBJECTIVE: Peptic ulcer disease (PUD) may present with different clinical findings, ranging from mild dyspeptic complaints to mortal complications, such as gastrointestinal system perforation. The aim of this study was to investigate the potential blood parameters that can be used in the diagnosis of PUD and prediction of complications.

PATIENTS AND METHODS: A total of 80 patients with dyspeptic complaints, 83 patients with PUD, and 108 patients with peptic ulcer perforation (PUP) who were treated in our hospital between January 2017 and December 2020 were included in the study. Clinical findings, laboratory data, and imaging methods were reviewed retrospectively.

RESULTS: The mean age of 271 (154 men, 117 women) patients included in the study was 56.04 ± 17.98 (mean ± standard deviation) years. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume, white blood cell, C-reactive protein, and neutrophil values were higher in patients with PUP compared to other groups (p < 0.001 for all). In the PUD group, only red blood cell distribution width was significantly higher compared to the patient group with dyspeptic complaints. In the postoperative period, NLR and PLR were significantly higher in patients who developed severe complications according to the Clavien-Dindo classification compared to patients who developed mild complications.

CONCLUSIONS: This study showed that simple blood parameters can be used as diagnostic markers at different stages of PUD. NLR and PLR can be helpful in the diagnosis of PUP and red blood cell distribution width can be used to differentiate patients with peptic ulcer from dyspeptic patients. Additionally, NLR and PLR can be used to predict serious postoperative complications after PUP surgery.

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